腹腔镜阑尾切胃穿孔修补.pptx

腹腔镜阑尾切除术腹腔镜阑尾切除术 Laparoscopic AppendectomyLaparoscopic Appendectomy阑尾切除术阑尾切除术式式1.传统阑尾切除术2.2.腹腔镜腹腔镜阑尾切除术传统阑尾切除术传统阑尾切除术切口选择寻找阑尾处理阑尾系膜处理阑尾根部放置引流处理原则：腹腔镜下阑尾切除术Kurt Semm(1983)传统阑尾切除术McBurney(1889)急诊手术腹腔镜阑尾切除术腹腔镜阑尾切除术Laparoscopic appendectomy腹腔镜胃十二指肠腹腔镜胃十二指肠穿孔修补术穿孔修补术LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCERLAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER 杨平杨平杨平杨平广东省佛山市第一人民医院胃肠外科广东省佛山市第一人民医院胃肠外科Perforated peptic ulcermorphology related to locationjuxta-pyloric ulcer:small,healthy bordergastric ulcer at lesser curvature:large,fibrotic edematous border(ulcus callosum)Perforated peptic ulcersealing off by left liver halfPerforated peptic ulcerfibrinous peritonitis+parahepatic collectionPerforated peptic ulcerulcer visible after lifting left liver lobe腹腹腔腔镜镜穿穿孔孔修修补补缝缝合合术术Perforated peptic ulcerlaparoscopic closurePerforated peptic ulcer(stapler-fixation of omentum)The end