“瓷化”样胆囊的腹腔镜切除技术探讨

The operative technique of laparoscopic cholecystectomy for porcelaneous gallbladder

目的:探讨“瓷化”样胆囊的腹腔镜切除技术。方法:37例根据术中胆囊三角的疤痕化程度,采用常规腹腔镜胆囊切除或胆囊横断法(缝合、明胶海绵加生物蛋白胶填塞、圈套器套扎闭合胆囊管)2种手术方式。结果:无中转开腹,常规法切除21例,横断法切除16例。平均手术时间分别为41m in、82m in。平均术中出血量为87m l、170m l。平均术后住院时间为2.8d、5.2d。仅1例发生术后胆漏,3d后自行停止。结论:采用适当的手术技术可以安全地完成“瓷化”样胆囊的腹腔镜切除。

Objective： To investigate the operative technique of laparoscopic cholecystectomy for porcelaneous gallbladder. Methods：There were 37cases in total. According to scar severity of the Calot triangle , two kinds of operation,including routine laparoscopic cholecystectomy and laparoscopic gallbladder amputation （tbe cystic duct was closed with sewing, glutin tamping and ligation with snave） were performed. Results：No patient was converted to open surgery. The routine LC were accomplished in 21 cases and the other 16 cases with the method of amputation. The mean operative time was 41 min and 82min and the blood loss was 87ml and 170ml respectively. The patient could be discharged at 2.8d and 5.2d postoperatively. Bile leak age was seen in only one case but stopped spontaneously at the third day postoperatively. Conelusions：We conclude that laparoscopic cholecystectomy for porcelaneous gallbladder can be performed safely with proper techniques.