71例急重症胆囊炎病人腹腔镜切除术的回顾性研究

A Retrospective Study on Laparoscopic Resection in Severe Acute Cholecystitis:a Report of 71 Cases

目的回顾分析急重症胆囊炎行腹腔镜下切除的手术效果.方法对急性化脓性胆囊炎、坏疽性胆囊炎、胆囊穿孔、胆囊颈部结石嵌顿等情况,采取灵活的方式分离粘连,显露、解剖胆囊周围组织关系,对部分病例采取胆囊部分切除术等方法完成腹腔镜下手术操作.结果71例患者,中转开腹4例,术后住院时间为5～11d,平均住院时间6.7d,放置腹腔引流管时间为2～9d,术后2例发生胆漏,经腹腔引流自愈.结论急重症胆囊炎采取合理的方法多可完成微创手术治疗,效果良好.

Objective To retrospectively analyze the effects of laparoscopic surgery on severe acute cholecystitis. Methods We completed laparoscopic surgery operation by taking flexible approach from adhesions, revealed and anatomy of organizations around the gallbladder and taking part gallbladder removal operation for some patients in situation of acute cholecystitis, gangrene cholecystitis, perforation of the gallbladder, gallblad- der neck stones incarcerated etc. Results The total of 71 cases, the conversion to open four cases, postoperative hospital stay for 5 to 11 days, the average length of stay 6.7 days, placing peritoneal cavity drainage tube for 2 to 9 days, 2 cases of bile leakage in the abdominal cavity Drainage self-healing. Conclusion The severe acute cholecystitis should to be completed minimally invasive surgery by reasonable approach and take good results.