57例胆囊术后残留病变的防治探讨

Prevention and treatment of residual lesion after cholecystectomy: a report of 57 cases

目的研究分析胆囊术后残留病变的治疗及预防经验。方法回顾性分析我院1999年4月—2006年7月期间收治57例胆囊术后残留病变者的临床资料。结果全部病人均再次手术治疗,残余小胆囊并炎症23例,残株结石29例,残株癌变4例,1例发生残端神经瘤。其中并发胆总管结石21例,并胆内胆管结石9例。结论重视胆囊切除术,合理处理胆囊管,合理应用腹腔镜手术,正确看待小切口手术是防治胆囊术后残留病变的关键。

Objeetive To discuss and analyze the methods for prevention and treatment of residual lesion after cholecystectomy. Methods The clinical data of 57 patients with residual lesion after cholecystectomy treated in our hospital from April 1999 to July 2006 were retrospectively analyzed. Results All the 57 patients received reoperation. Of the 57 patients, 23 had residual gallbladder and inflammation, 29 residual stones, 4 residual gallbladder cancer and 1 neural tumor of the residual end. Complication of cholangiolithiasis was found in 21 patients and that of bile duct stones in 9. Conelusion Attaching importance to gallbladder operation, dealing with bile duct perfectly, not cutting gallbladder with laparoscope grudgingly and looking upon small-cut operations correctly are important for prevention and treatment of residual lesion after cholecystectomy.