Ramazanov R M
Khirurgiia (Mosk). 2000(10):28-30.
The experience of effective work of endoscopic service in district hospital, including surgeon and gynecologist in laparoscopic team is presented. The results of 1000 laparoscopic cholecystectomies were analyzed. In 868 cases the operation was performed for chronic and in 132 cases--for acute calculous cholecystitis. The additional endoscopic retrograde pancreatocholangiography and papillosphincterotomy (if it was necessary) was performed in patients with cholangitis and obstructive jaundice and also with choledocholithiasis, revealed during elective examination. In 33 cases in thick infiltrate of gall bladder neck or neck congenital anomalies, laparotomy was performed, 30 patients underwent minilaparotomy. Simultaneous operations were performed in 116 (11.6%) patients. In early postoperative period, the complications were seen in 8 patients. In 2 cases the injury of common hepatic duct was observed. Suppuration of paraumbilical wound was seen in 13 patients, postoperative paraumbilical hernia (4-6 months after operation)--in 18 patients. There were no cases of lethal outcomes.
介绍了地区医院内镜服务的有效工作经验,包括腹腔镜团队中的外科医生和妇科医生。分析了1000例腹腔镜胆囊切除术的结果。其中868例手术针对慢性胆囊炎,132例针对急性结石性胆囊炎。对患有胆管炎、梗阻性黄疸以及在择期检查中发现胆总管结石的患者,进行了额外的内镜逆行胰胆管造影和乳头括约肌切开术(如有必要)。在33例胆囊颈部有增厚浸润或颈部先天性异常的病例中,进行了剖腹手术,30例患者接受了迷你剖腹手术。116例(11.6%)患者进行了同期手术。术后早期,8例患者出现并发症。观察到2例肝总管损伤。13例患者出现脐周伤口化脓,18例患者出现术后脐周疝(术后4 - 6个月)。无死亡病例。