急性胆囊炎腹腔镜手术时机探讨及操作技巧

The Operative opportunity and surgical technique of laparoscopic cholecystectomy for acute cholecysitis

目的探讨急性胆囊炎行腹腔镜胆囊切除术的手术时机,并总结操作技巧。方法回顾性分析2000年6月￣2005年6月265例腹腔镜胆囊切除术治疗急性胆囊炎的临床资料。结果265例中手术成功244例,成功率92.1%。中转开腹21例,其中小于72小时(Ⅰ组),超过72小时(Ⅱ组)的中转率分别为3.1%(4/129),12.5%(17/136)。Ⅰ组与Ⅱ组比较成功率无明显差别(P>0.05)。全组无死亡病例,也无严重并发症发生。结论急性胆囊炎行腹腔镜胆囊切除术安全可行,只要无内科禁忌证,应积极开展腹腔镜手术。

Objective To investigate the operative opportunity of laparoscopic cholecystectomy （LC） for acute cholecysitis,and sum up the surgical technique of LC.Methods Clinical records of 265 cases of acute cholectstitis treated by LC from June 2000 to June 2005 were respectively reviewed. Results 265 cases of acute cholecystitis were uccessfully operated.There was no operative death and no complication occurred,The success rate was 92.1%.21 cases were converted to laparotomy.The conversion rate of the acute onset within 72 hours （group Ⅰ ）,Beyond 72 hours （group Ⅱ ） was 3.1%（4/129）,12.5%（17/136）.There was no significant difference between group Ⅰ and group Ⅱ （P〉0.05）.Conclusion Since LC is a feasible,safe and effective method to treat acute cholecysitis.It should be recommended,except patients who combined with taboo syndrome of medicine.