【摘要】  目的 探讨小切口胆囊切除术的优点。 方法 对100例小切口胆囊切除术进行临床分析，将小切口胆囊切除术（MC） 、传统胆囊切除术（OC）、腹腔镜胆囊切除术（LC）进行扼要比较。 结果 切口长度4～6cm，平均手术时间40min。患者当日起床，次日进食，平均术后住院5天，无术中胆道损伤、术后出血、胆漏、切口感染发生。 结论 在OC熟练基础上开展是安全可行的。由于MC具有直观显露术野便于手术操作的优点，故有良好的应用价值。

【关键词】  传统胆囊切除术（OC）;腹腔镜胆囊切除术（LC）;小切口胆囊切除术（MC）

    Clinical analysis on 100 cases of minilaparotomy cholecystectomy（MC）

    【Abstract】    Objective  To discuss the advantages of MC.   Methods  100cases which received the operation of MC were analyzed clinically, the operative methods of MC was introduced, and the concise comparison between MC and OC,LC was made respectively.  Results  The incision were averagely 4～6cm in length ,and mean operation time was 40min .Patients who received the operation were capalbole of primary exercises without bed the first day and oral intake can be expected the next day .The mean postoperative hospitalized time was five days .No bile duct injury、postoperative haemorrhage、bile leakage and incision infection occurred.  Conclusion  To skillfully operate  the conventional chotecystectomy in basis could be safely performed with MC,Owing to the advantages of more direct exposure of operation field and easy performing skills ,MC was of great use in practice.

    【Key words】  traditional cholecystectomy;laprosopic cholecystectomy;minilaparotomy cholecystectomy

    随着医疗技术的进步及患者要求的提高,胆囊切除术在近年来有了很大的发展。目前单纯性的胆囊切除的术式主要有传统胆囊切除术（OC）,腹腔镜胆囊切除术（LC），小切口胆囊切除术（MC）。

    目前,在LC迅速开展的启发下,MC［1］已引起人们的普遍关注,现就我院已施术100例小切口胆囊切除术（MC）,结合文献及本院病例报告,介绍如下。

    1  临床资料

    1.1  一般资料  2003年1月～2006年6月我院共施行MC 100例,男39例，女61例，其中胆囊结石79例,胆囊息肉21例。术前患者不置留胃管，均放置小引流管引流（24～48h拔除），无1例发现胆漏、腹腔出血、感染、胆道损伤等，术后不使用止痛药，绝大多数患者当日可自行下床活动，次日进流质。

    1.2  手术方法  全麻或硬膜外麻醉即可，切口选择右肋缘下1cm,做平行于肋弓的斜切口，切口以第9肋下缘与腹直肌外缘相交为中心，长约4～6cm,切        开腹直肌前鞘，切开长度略长于皮肤，电刀切断或钝性分开腹直肌，其他肌层电刀切断。 进腹腔后一般先结扎胆囊动脉和胆囊管，胆囊管暂不切断，必要时胆囊减压，然后用电刀或剪刀自胆囊底部分离胆囊至胆囊管，切断胆囊管去胆囊,将胆囊管残端双重结扎，胆囊床无明显渗血或胆汁漏出者可不缝合，术毕可不置引流，逐层闭腹，皮肤可用皮内缝合。

    1.3  临床效果  本组MC病例中,术后平均住院时间5天,