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Objectives To sum up the experience of the gasless laparoscopic surgery using home-made abdominal-wall-take-up.Methods Using home-made abdominal-wall-take-up application on 15 patients,including 12 cholecystectmy,3 appendectomy.Every patients was used epidural block.Results All the surgery were successed and every patients had no complication.The hospitalization was 4～40 days (average 13.6 days),the time of operation was 50 to 215 minutes (average 89 minutes), fee of hospitalization was 5487 yuan.Conclusions It conclude that the gasless laparoscopic surgery using home-made abdominal-wall-take-up application is a safe,economic,useful method,which adapts to the situation of China.It reinforces the gas laparoscopic surgery.
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Objective To explore the feasibility and the selection of laparoscopic cholecystectomy(LC) for the treatment of acute gallstone pancreatitis(AGP) without jaundice.Methods Laparoscopic cholecystectomy had been performed in 95 patients with AGP accompanying no jaundice from July 1996 to July 2004 in this hospital.All of the patients had a history of conservative treatment.Selective LC was performed in 79 patients after their symptoms were relieved,while emergent LC was required in 16 patients because of failure of response to conservative treatment.Results All the operations were successfully completed.The operation time was 40~328 min(mean,103 min),and the intraoperative blood loss was 0~210 ml(mean,35 ml). Intraoperative cholangiography was carried out in all the 95 patients and succeeded in 92.Thirteen patients were found having lower common bile duct stones and then were cured with endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic spincterotomy(EST).No conversion to open operation was required.No postoperative biliary hemorrhage or leakage occurred.No fatal case was seen.Pathological examinations following operation revealed multiple small or sand-like stones in the gallbladder.Follow-up in 39 patients for 1 months ~ 5 years found no recurrence of pancreatitis or cholelithiasis.Conclusions Laparoscopic cholecystectomy should be performed as early as possible in the treatment of AGP without jaundice.Use of intraoperative cholangiography and postoperative EST should be emphasized in proper cases.
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Objective To study the practical clinical value of laparoscopic cholecystectomy(LC) combined with other laparoscopic surgery. Methods 206 patients treated by LC combined with other laparoscopic surgery were analysed retrospectively. Results Among the 206 cases of LC combined with other laparoscopic surgery, LC was combined with choledochal exploration in 64 patients, with appendectomy in 29 patients, with fenestration of hepatic cyst in 38 patients, with other hepatic operations in 13 patients, with unroofing of kidney cyst in 15 patients, with release of abdominal adhesions in 31 patients, and with other operative procedures in 16 patients. Laparoscopic operations were successful in 204 patients, and 2 patients were converted to laparotomy. Postoperative bile fistula occurred in 2 patients; 1 healed with conservative therapy, and 1 healed after reoperation. Conclusions Laparoscopic cholecystectomy combined with other laparoscopic surgery can adequately present the advantages of microsurgery by safe, effective and economical management of various abdominal diseases.