慢性结石性胆囊炎急性发作手术时机的选择

Research of operative time for acute calculous cholecystitis

目的探讨慢性结石性胆囊炎急性发作手术时间的选择。方法总结病历资料，分析慢性结石性胆囊炎急性发作手术时间选择对手术难易程度、术后恢复情况、术中术后并发症等的影响。结果手术早期即发病后12h内行胆囊切除术18例，除1例胆囊萎缩手术时间超过1h外，12例行胆总管探查手术，均在1h内完成且无并发症发生。12h后手术158例，术中发现胆囊水肿随时间延长而加重，其中25例化脓，4例穿孔，2例术后并发感染性休克死亡。结论慢性结石性胆囊炎急性发作在诊断明确、无手术禁忌证的情况下，手术越早胆囊炎症越轻，手术难度越小，术后恢复快，术中术后并发症少。

Objective To investigate the operative time for acute calculous cholecystitis. Methods From Aug 2006 to Aug 2008,190 patients with acute calculous cholecystitis were analyzed retrospectively. Results In the early stage of 12 h after onset, 12 cases performed exploration of the common bile duct were with 1 hour and no complication were observed except one case＇s operative time exceeded one hour because of atrophy of gallbladder. After 12 h of onset, 158 cases were performed hydrocholecystis,25 cases suppuration,4 cases perforation and 2 case death of septic shock. Conclusion Acute cholecystitis with cholelithiasis with clear diagnosis and no contraindication of surgery, might be surgery sooner because of light cholecystitis, quick postoperative recovery and less post - operative complications.