胆囊结石伴急性胆源性胰腺炎的腹腔镜胆囊切除术

Laparoscopic Cholecystectomy for Gallstones Complicated with Acute Biliary Pancreatitis

目的探讨胆囊结石伴急性胆源性胰腺炎(acute biliary pancreatitis,ABP)实施腹腔镜胆囊切除术(laparoscopiccholecystectomy,LC)的可行性及手术时机。方法1999年1月~2007年8月,行LC治疗72例胆囊结石伴ABP。56例经非手术治疗胰腺炎缓解后早期(≤2周)行LC,8例延期(1~3个月)行LC,8例非手术治疗效果不佳而急诊行LC。结果72例LC均获成功。手术时间30~135min,平均63min。术中出血量20~230ml,平均50ml。术中胆道造影5例,均成功。造影发现4例胆总管下段结石,术后行逆行性胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)联合内镜下十二指肠括约肌切开术(endoscopic sphincterotomy,EST)取石成功。中转开腹1例,无围手术期死亡,无术后出血及胆漏并发症。2例术后4d急性胰腺炎复发,保守治愈。72例随访2个月~8年,平均19个月,无胰腺炎、胆总管结石复发。结论对胆囊结石伴急性胆源性胰腺炎患者,如能慎重选择病例,做好必要的围手术处理,早期实...

Objective To explore the feasibility and proper time of laparoscopic cholecystectomy(LC)for the treatment of gallstones complicated with acute biliary pancreatitis(ABP).Methods From January 1999 to August 2007,72 patients with gallstones complicated with ABP were treated with LC in our department.Among the patients,early LC was performed on 56 cases when their symptoms of pancreatitis were relieved,elective LC was carried out in 8 patients,while emergent LC was required in the other 8 patients because of fa...