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find Author "吴尚卫" 2 results
  • Feasibility Through Confluence of Common Bile Duct and Cystic Duct Approach with Mini-Incision in LaparoscopicCommon Bile Duct Exploration

    Objective To investigate the feasibility and patient selection of T-tube free laparoscopic common bileduct exploration through mini-incision in confluence of common bile duct (CBD) and cystic duct. Methods The clinical data of 52 patients who underwent CBD exploration from January 2009 to December 2011 were retrospectively analyzed. A 3-4mm longitudinal incision of anterior wall of CBD was made along the confluence of CBD and cystic duct, and then the choledochoscope was inserted into CBD through this mini-incision for the exploration and treatment by laparoscopy and choledochoscopy, the incision was sewed up by T-tube free primary suture. Results All 52 cases were cured and stone clearance rate was 100% as revealed by choledochoscopy and cholangiography. The time of operation, intraoperativecholangiography, removal of stones with help of choledochoscope, and removal drainage tube after operation was from 90 to 200 min with an average of 100min, 3 to 10min with an average of 6min, 5 to 15 min with an average of 8 min,and 3-5d with an average of 3.5d , respectively. The drainage flow was 20-60mL/d with an average of 30mL/d. No biliary leakage, abdominal pain, and choloplania or infection of incision was observed following operation. The hospital stay was 5 to 12d with an average of 6.5d after operation. No calculus regeneration or bile duct stricture occurred during following-up of 3 to 40 months with an average of 20 months. Conclusion With proper patient selection, T-tube free laparoscopic CBD exploration through mini-incision in confluence of CBD and cystic duct is safe and feasible by proficient surgeons in laparoscopy and choledochoscopy.

    Release date:2016-09-08 10:23 Export PDF Favorites Scan
  • 腹腔镜胆囊切除术中转开腹相关因素分析

    目的探讨腹腔镜胆囊切除术(LC)中转开腹的相关因素。 方法回顾性分析2002年12月至2012年12月期间笔者所在医院6 038例LC中168例中转开腹患者的临床资料。 结果本组中转开腹率为2.8%,其中主动中转开腹120例,主要原因为胆囊三角及胆囊与周围组织严重粘连、胆总管及胆囊管变异等;被动中转开腹48例,主要原因为术中出血镜下难以处理(胆囊床、胆囊动脉损伤等)、肝外胆管损伤等。168例均成功完成相应手术,术后恢复顺利,治愈出院。 结论LC术中转开腹的发生与多种因素有关,其常见原因有手术区严重粘连、肝外胆管损伤等。提高技术水平、严格掌握LC的适应证,可降低中转开腹率,及时中转开腹可减少严重并发症的发生。

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