Closed establishment of pneumoperitoneum in patients with peritoneal adhesion in laparoscopic cholecystectomy
- VernacularTitle:腹腔粘连患者腹腔镜胆囊切除术闭合法建立气腹
- Author:
Mingchen BA
;
Hui JING
;
Xunru CHEN
;
Jingxi MAO
;
Zhengdong ZHOU
- Publication Type:Journal Article
- Keywords:
PERITONEAL ADHESION/surg;
CHOLECYSTECTOMY,CAPAROSCOPY;
PNEUMOPERITONEUM ARTIFICIAL
- From:
Chinese Journal of General Surgery
2001;10(1):46-48
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the way of closed establishment of pneumoperitoneum(CEPP) in patients with peritoneal cvity adhesion in laparoscopy cholecystectomy(LC). Methods CEPP experiences of 1046 patients in 6600 cases LC in our hospital from September 1991 to September 1999 were retrospectively analysed. The difficulty in establishing pneumoperitoneum was divided into two kinds: real establishment pneumoperitoneal difficulty(REPPD) and false establishment pneumoperitoneal difficulty(FEPPD). REPPD was due to Veress needle penetrating into visceral or extensive adhesion in peritoneal cavity resulting in CO2 flowing into difficulty. FEPPD was due to Veress needle pentrating in the fat out of peritoneum, in round hepatic ligament or in greater omentum. The formal situation needed to open laparotomy as a change, and the latter situation could establish pneumoperitoneum successfully by regulating the Veress needle penetrating direction or depth in the second penetration. Results Of the 1046 patients, 1028 cases had been establishedpneumoperitoneum successfully though CEPP; 6 cases of REPPD and 18 of FEPPD were required opening laparotomy as a change. The successful rate of CEPP was 98.3%. Conclusions CEPP is a safe and feasible method in patients with peritoneal adhesion in LC. It is the main reason for CEPP failure regarding REPPED as FEPPD made by the deficiency in LC experience and loss confidence in laparoscopist.
