肝硬化患者行腹腔镜胆囊切除术的临床分析

Laparoscopic cholecystectomy for patients with liver cirrhosis

目的:探讨肝硬化患者腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的可行性、安全性及手术技术特点。方法:回顾分析120例Child A、B级肝硬化患者行LC的临床资料。结果:中转开腹8例。中转原因:结石嵌顿、Calot三角粘连5例;术中出血,镜下止血困难2例;术中发现胆道变异1例。LC平均手术时间(40.3±12.5)min,术中平均出血(60.8±19.5)ml,术中无损伤,术后出血、肺部感染、泌尿系感染各1例。无肝功能衰竭等严重并发症,均治愈出院,术后平均住院(5.2±2.0)d。结论:对于Child A、B级肝硬化患者,LC是一种安全可行的微创手术。

Objective： To evaluate the feasibility, safety and technical characteristics of laparoscopie cholecysteetomy （LC） in patients with hepatic cirrhosis. Methods：LC were performed in 120 patients with liver cirrhosis of Child A and B,and clinical data were analyzed retrospectively. Results：LC was successfully performed in 112 patients. 8 cases were converted to open cholecysteetomy（ OC）, among whom 5 cases were because of stone incarceration and dense adhesion of Calot triangle ,2 cases of difficult management of bleeding under laparoscopy and 1 cases of anatomic variation of external hepatic hiliary duct. The average operation time of LC was （40.3± 12.5） mirl and the average blood loss was （60.8 ± 19.5）ml. There was rio injury during the operation. Postoperative complications included bleeding in 1 case,respiratory tract infection in 1 case,and urinary tract infection in 1 case. All patients recovered smoothly and discharged from hospital （5.2 ± 2.0）days after LC. Conelusions：Laparoscopic cholecystectomy is a feasible and safe minimal invasive operation in patients with liver cirrhosis of Child A and B.