门静脉高压症腹腔镜胆囊切除术13例临床分析

Laparoscopic cholecystectomy in patients with portal hypertension: a clinical analysis of 13 cases

目的分析肝硬变门静脉高压症病人腹腔镜胆囊切除的手术适应证和手术方法。方法A组为该院1998～2005年13例门静脉高压症的胆囊结石病人行腹腔镜胆囊切除术。B组为随机抽取同期腹腔镜胆囊切除术200例,将两组进行比较。结果病人手术顺利,无术后再出血及中转开腹。A组手术时间及术后住院日长于对照组。A组病人术后胆囊床积液及发热高于对照组。结论腹腔镜胆囊切除术对于正确选择的肝硬变门静脉高压症胆囊结石病人是安全的。

[Objective] To evaluate the indications for laparoseopie eholecystectomy（LC）in patients with portal hypertension and the methods of the procedure. [Methods] In group A, 13 gallstone patients with portal hypertension were underwent pneumopefitoneum LC from 1998 to 2005. In group B, 200 cases of laparascopic chelocystectomy （LC） were randomly seleted. These two groups were compared by statistic method. [Result] All patients recovered uneventfully. No postoperative haemorrhage was observed. No patient was converted to open surgery. The operation time and postoperation stay in group A were longer than the control. The morbidity of postoperational peritoneal fluid collection and fever in group A were higher than the control group. [Conclusion] For reasonably selected gallstone patients with portal hypertension, LC is safe.