目的:分析經后腹腔鏡腎上腺囊腫去頂減壓術的療效,安全性和臨床價值。方法:我院2004年12月至2007年12月6例經后腹腔鏡腎上腺囊腫去頂減壓臨床資料進行回顧分析。結果:經后腹腔鏡5例腎上腺囊腫患者順利切除去頂,其中左側腎上腺囊腫3例,右側腎上腺囊腫3例。1例轉開放,為雙側腎上腺囊腫。平均手術時間(45.73±1.32)min,平均術中出血量(7.35±0.45)mL。平均住院天數(7.67±0.24)天,平均術后住院天數(5.0±0.11)天。結論:經后腹腔鏡腎上腺囊腫去頂減壓是一種安全,有效且可行的治療方式,必要時應及時轉開放。
3.2 腹腔鏡左半結腸切除術3.2.1 手術要點 腹腔鏡左半結腸切除術的要求往往高過腹腔鏡右半結腸切除術，所以，除一套腹腔鏡器械外，還應增備一套開腹手術器械，一旦腹腔鏡手術中出現難以控制的出血以及必須開腹處理的特殊情況，應毫不猶豫中轉開腹手術。......
【Abstract】Objective To investigate prophylactic measures for nontraumatic complications of laparoscopic cholecystectomy (LC).Methods The data of 13 000 patients who underwent LC in Kunming general hospital of PLA over 13 years(1991-2004) were retrospectively reviewed. Results Nine malignant tumors and 47 common bile duct stones were missed at LC. The 9 malignant tumors included hepatic cancer (n=1), gastric cancer (n=1), gallbladder cancer (n=2), pancreatic cancer (n=2) and right colon cancer (n=3). Of all the carcinomas, 3 patients with right colon cancer underwent colectomy, the other 6 patients couldn’t be cured radically. All the 47 patients with choledocholithiasis were cured successfully, among them 31 patients were performed with ERCP and 16 were reoperated on with cholangiotomy. Conclusion This study emphasizes the necessity to analyze carefully patients’ symptoms before operation and pay attention to pathological changes of gallbladder and intraabdominal situation intraoperatively. If necessary, laparoscopic ultrosonography can be used to avoid missing malignant tumors and biliary stones.