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目的总结慢性结石性胆囊炎合并卵巢囊肿经腹腔镜联合手术治疗的效果。方法对于患慢性胆囊炎胆囊结石合并卵巢囊肿的病人,选择腹腔镜联合摘除手术,常规术中胆道造影,卵巢囊肿超过70mm,或手术间隙较小,可先行穿刺减压后手术摘除,术中常规病理检查。结果全组372例患慢性胆囊炎、胆囊结石、卵巢囊肿全部联合手术成功。其中单侧单发囊肿287例,单侧多发囊肿58例为术中发现,双侧单发囊肿27例。单侧卵巢切除4例。下腹部置腹腔引流管21例,胆囊床置引流管11例,术后36h进食,下床活动,5￣7d出院。332例联合微创手术,术中常规胆道造影未发现胆道结石,全部病例无医源性器官损伤。结论在胆囊、附件联合手术时,常规术中胆道造影可预防胆道残留结石,术中卵巢成型,可预防盆腔、卵巢粘连,保护卵巢功能,术中常规病理检查可预防恶性病变遗漏。
Objective To summarize the effect of laparoscopic combined surgery on chronic cholecystitis with ovarian cyst. Methods For patients with chronic cholecystitis gallbladder stones combined with ovarian cysts, laparoscopic surgery combined with cholecystectomy, routine intraoperative cholangiography, ovarian cysts more than 70mm, or smaller surgical space, puncture and decompression surgery can be removed prior to surgery routine Pathological examination. Results The whole group of 372 cases of chronic cholecystitis, gallstones, ovarian cysts all combined surgery was successful. Among them, 287 cases of unilateral single cyst and 58 cases of unilateral cyst were found in operation and 27 cases of bilateral single cyst. Unilateral ovariectomy in 4 cases. The lower abdomen was placed in 21 cases of abdominal drainage tube, drainage tube in 11 cases of gallbladder bed, 36h after eating, out of bed activities, 5 ~ 7d discharge. 332 cases of combined minimally invasive surgery, intraoperative conventional cholangiography found no biliary stones, all cases of iatrogenic organ damage. Conclusions In the combined operation of gallbladder and appendix, routine intraoperative cholangiography can prevent residual bile duct stones and intraoperative ovarian formation, which can prevent pelvic and ovarian adhesions and protect ovary function. Conventional pathological examination can prevent the omission of malignant lesions.