[摘要] 目的 分析和总结腹腔镜阑尾切除术中转开腹的原因，探讨中转开腹的指征。方法 回顾统计我院腹腔镜阑尾切除术352例，术中和术后中转开腹手术21例，发生率为6%(21/352)，对中转的主要原因进行分析讨论。结果 导致中转的主要原因有：阑尾致密粘连或包裹(15/21)、位置异常(14/21)、根部坏疽或穿孔(9/21)、术中术后出血(2/21)等；合并2种或2种以上异常情况下的中转率高达86%。 结论 阑尾的炎症程度和位置是中转开腹的主要因素，及时中转是减少手术死亡率和并发症的关键因素。

    [关键词] 腹腔镜；阑尾切除术；中转开腹

    Analysis of causes and indications of conversion to open laparotomy in laparoscopy appendectomy

    LIU Wen-sheng,GAN Yi.

    Yiyang People’s Hospital,Hunan 413000,China

    [Abstract] Objective To analyse the causes of conversion to open laparotomy in laparoscopy appendectomy and to discuss the indications of it.

    Methods We reviewed the clinical datum of 352 patients having undergone laparoscopic appendectomy from 1999 to 2006, 21 of whom (6%) having received conversion to an open procedure.We analysed the primary causes and summarized the indications of conversion.

    Results The conversion was mainly due to close conglutination(15/21), deep position of the appendix (14/21), perforated or gangrenous appendicitis(9/21) and bleeding(2/21).When two or more above conditions co-existed, the probability of conversion would increase greatly up to 83%. ......