急性结石性胆囊炎的腹腔镜手术治疗(附232例报告)

Experience of laparoscopic cholecystectomy for acute cholecystitis with gallstone(232 cases report)

目的探讨腹腔镜胆囊切除术治疗急性结石性胆囊炎的经验。方法总结2005年3月～2008年6月收治的232例急性结石性胆囊炎患者的病例资料。结果该组232例急性结石性胆囊炎患者15例中转开腹,其中3例为Mirizzi综合征,12例为胆囊三角结构严重粘连,其余病例均行腹腔镜胆囊切除术,2例并发术后出血,第2次腹腔镜手术止血,3例术后出现胆漏,均保守治疗痊愈。结论只要能把握住手术时机并注重手术技巧,急性结石性胆囊炎患者行LC是安全可行的。

[Objective] To discuss the experience of laparoscopic cholecystectomy （LC） for acute cholecystitis with gallstone. [Methods] 232 cases of acute cholecystitis treated by LC in our department from Mar 2005 to Jun 2008 were analyzed. [Results] LC was accomplished in 217 cases, while conversions to open surgery were required in 15 cases （3 eases of Mirizzi＇s syndrome, 12 eases of serious adhesions in the Calot triangle）, Re-exploration ＆ stopping bleeding by laparoseopy was performed in 2 eases because of post-operation bleeding, Guard-treat was performed in other 3 eases with biliary leakage after operation. [Conclusion] LC is safe and feasible for acute eholecystitis with gallstone on the basis of the proper opportunity and surgical techniques.