Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is a minimally invasive surgery that is the result of a combination of modern high-tech and traditional surgical techniques. Its greatest advantage is that there is no abdominal surgical incision in the traditional sense, which avoids all kinds of damage and discomfort caused by the surgical incision. Treatment of diseases: cholecystitis, chronic cholecystitis, acute cholecystitis Indication 1. Symptomatic gallstones. 2. Symptomatic chronic cholecystitis. 3. Gallstones with a diameter > 3 cm. 4. Filled with gallstones. 5. Symptomatic and gallbladder bulging lesions with surgical indications. 6. Acute cholecystitis after treatment, symptom relief, surgical indications. 7. Gallbladder single polyps more than 1.0cm in diameter; pedicle thick, especially in the neck of the gallbladder, older than 50 years old. 8. Gallbladder multiple polyps with gallstones; symptomatic, older than 50 years old. 9. Gallbladder polyps with clinical symptoms. 10. Gallbladder single polyps, less than 10mm, asymptomatic, younger than 50 years old, allow observation, follow-up; if the lesions increase or the shape changes, surgery should be treated. 11. Gallbladder polypoid lesions, with obvious symptoms and repeated authors. 12. Gallbladder polyps less than 5mm in diameter asymptomatic patients should be followed up for 3 to 5 months. Surgical treatment is required once the lesion is rapidly enlarged or the symptoms are obvious. Contraindications Relative contraindications: 1. Chronic atrophic calculous cholecystitis. 2. Secondary common bile duct stones. 3. Have a history of upper abdominal surgery. 4. Physical obesity. 5. Abdominal hernia. Absolute contraindications: 1. Acute cholecystitis with severe complications, such as gallbladder empyema, gangrene, perforation, etc. 2. Gallstone acute pancreatitis. 3. Accompanied by acute cholangitis. 4. Primary common bile duct stones and intrahepatic bile duct stones. 5. Obstructive jaundice. 6. Gallbladder cancer. 7. Gallbladder bulging lesions are suspected of cancer. 8. Liver hardening portal hypertension. 9. Middle and late pregnancy. 10. Abdominal infection, peritonitis. 11. Chronic atrophic cholecystitis, gallbladder > 4.5 × 1.5CM, wall thickness > 0.5CM (B-mode ultrasound measurement). 12. With bleeding disorders, coagulopathy. 13. Important organs are insufficiency and difficult to tolerate surgery. 14. The general condition is poor, it is not suitable for surgery or the patient is old, and there is no strong indication for gallbladder resection. 15. Hey. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure In the umbilical incision, insert a laparoscope, place a 5 mm trocar cannula under the right rib, clamp the gallbladder with a special pliers, and place a 10 mm trocar cannula on the right side of the midline, hook or The claw-shaped coagulator, the clamp and the scissors are used to separate the gallbladder bed, so that the gallbladder is freed. The gallbladder artery and the cystic duct were clamped with a clamp, and they were respectively clamped with a special titanium nail, and the gallbladder artery and the cystic duct were cut with scissors, and the gallbladder was lifted with a forceps and taken out from the abdominal wall incision. Excessive or excessive stones can be combined with the stone to allow the gallbladder to be removed from the incision.

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