用Hem-o-Lok结扎夹行腹腔镜胆囊切除-《中国微创外科杂志》

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Author(s):: Ying Rongchao; Jin Huicheng; Zhang Jian; et al.; Department of General Surgery, Hangzhou First Hospital, Hangzhou 310006, China

摘要:: 目的探讨使用Hem-o-Lok结扎夹行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的方法及优势.方法用Hem-o-Lok结扎夹对288例胆囊结石及胆囊息肉样病变施行LC,均采用三孔法. 结果手术均获成功,无中转开腹,264例(92%)用中大号(ML)结扎夹,剑突下切口几乎无痛感,术后平均住院时间2.7 d(1～3 d).另24例因手术困难改用大号(L)结扎夹,均成功.无出血、胆漏、胆管损伤等并发症. 结论使用中大号(ML)Hem-o-Lok结扎夹行LC,可使剑突下切口仅5 mm,使用常规的腹腔镜手术设备即可.

Abstract:: Objective　To explore the use and advantages of theHem-o-lok ligating clip in laparoscopic cholecystectomy (LC).　M ethods　A 3-port approach laparoscopic cholecystectomy by applying theHem-o-lok ligating clip was performed in 288 patientswith cholecystolithiasis or cholecystic polypoid lesion.　Results　All the operations were successfully fulfilled, without conversions to open surgery. Amiddle-to-large sized clipwas used in 264 patients (92% ), who almosthad no painful feeling in the xiphoid process incision and had a mean postoperative hospital stay of 2·7 days(1~3 days). A large sized clip was successfully utilized in 24 patients because of the difficulty encountered during the ligation using themiddle-to-large sized clip. No hemorrhage, biliary leakage, or bile duct injuries happened.　Conclusions　Laparoscopic cholecystectomy using the middle- to- large sized Hem-o-lok ligating clip and other routine laparoscopic devices canminimize the xiphoid process incision as short as 5 mm.