腹腔镜胆囊切除术在合并肝硬化患者中的应用

Laparoscopic cholecystectomy using in the patiants associated with cirrhosis

目的探讨腹腔镜胆囊切除术(LC)在治疗胆囊良性病变合并肝硬化患者中的意义。方法对我院自1999年以来44例胆囊良性病变合并肝硬化(Child鄄Pugh肝功能分级为A或B级)的患者在腹腔镜下行胆囊切除进行回顾性分析。结果大部分患者术后恢复良好,仅4例术后出现腹水,经护肝、营养支持及利尿治疗,7d后腹水均消失,无1例出现肝昏迷和死亡。结论:在术前充分做好各项检查及准备,术中及术后恰当的处理,胆囊良性病变合并肝硬化的腹腔镜手术治疗是安全有效的;但术中操作应注意避开曲张的血管、严密止血,注意无菌操作,防止腹腔内污染。

Objective To investigate the significance of laparoscopic cholecystectomy（LC） in the treatment of the patiants with gall bladder disease associated with liver cirrhosis. Methods From 1999 to date,44 cases with gallbladder benign diseases associated with liver cirrhosis received LC were analyzed retrospectively.Results Most of patients were recovered well.The ascites was happened only 4 cases after operation.No liver coma and death case were found during hospitalization. Conclusion In making enough preoperative preparation and appropriate intraoperative and postoperative management, the LC is safe and effective for the treatment of gallbladder benign diseases associated with liver cirrnosis.It is very important to avoiding injury of varicose veins,strict hemostasis,paying attention to aseptic manipulation and preventing intraperitonial contamination during LC.