腹部手术患者腹腔镜胆囊切除术

腹部手术患者腹腔镜胆囊切除术

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摘要：
背景：腹腔镜cholecystctomy已成为有症状的胆囊结石的首选治疗方法。使用腹腔镜手术在患者腹部手术，外科医生劝阻了一些潜在的风险。因此，我们的目的是探讨腹腔镜胆囊切除术的可行性和安全性上腹部手术的效果。
方法：本研究共纳入600记录患者胆结石谁接受腹腔镜cholecystctomy，在2000年5月和2004年1月，我们在外科手术部门之间的。将患者分为3组：第1组，患者无腹部手术史组（n = 408）; 2组患者的历史上腹部手术组（n = 92），3组患者的历史下腹部手术组（n = 100）。为开放式的转换率，手术时间，围手术期及术后并发症，住院天数的数据收集和分析。
结果：经历了腹部手术的600名研究中，192例（92上，100下）。各组的转化率，住院时间，并发症发生率相似。平均手术时间是最长的（57±9.8分钟），与以前的上腹部手术的患者（P <0.05）。另一方面，其执行时间是相似的组1和组3（P> 0.05）。
结论：腹部手术是安全的腹腔镜胆囊切除术的禁忌证。然而，以往的上腹部手术与延长操作时间。

Laparoscopic Cholecystectomy in Patients With Previous Abdominal Surgery
Authors: Akyurek, Nusret; Salman, Bülent; Irkorucu, Oktay; Tascilar, &Ouml;ge; Yuksel, Osman; Sare, Mustafa; Tatlicioglu, Ertan
Source: JSLS, Journal of the Society of Laparoendoscopic Surgeons, Volume 9, Number 2, April - June 2005 , pp. 178-183(6)

Abstract:
Background: Laparoscopic cholecystctomy has become the treatment of choice for symptomatic gallstones. The potential risks have dissuaded some surgeons from using the laparoscopic procedure in patients with previous abdominal surgery. Therefore, we aimed to investigate the effect of previous abdominal surgery on the feasibility and safety of laparoscopic cholecystectomy.
Methods: This study included 600 well-documented patients with gallstones who underwent laparoscopic cholecystctomy at our surgical department between May 2000 and January 2004. The patients were classified into 3 groups: group 1, patients without a history of previous abdominal surgery (n=408); group 2, patients with a history of upper abdominal surgery (n=92); group 3, patients with a history of lower abdominal surgery (n=100). The data were collected and analyzed for open conversion rates, operative times, perioperative and postoperative complications, and hospital stay.
Results: Of the 600 study patients, 192 had undergone previous abdominal surgery (92 upper, 100 lower). Conversion rate, hospital stay, and complication rates were similar in each group. Mean operating time was the longest (57±9.8 min) in patients with previous upper abdominal surgery (P<0.05). On the other hand, the operative time was similar in groups 1 and 3 (P>0.05).
Conclusion: Previous abdominal surgery is not a contraindication to safe laparoscopic cholecystectomy. However, previous upper abdominal surgery is associated with a prolonged operation time.