腹腔镜在急性胆囊结石嵌顿手术中的应用

Application of Laparoscopy Inoperation for Gallbladder Calculi Incarceration

目的:总结急性胆囊炎伴结石嵌顿患者行急诊腹腔镜胆囊切除术(ELC)的时机、可行性及治疗经验。方法:回顾分析我院近5年腹腔镜手术治疗175例急性胆囊结石嵌顿患者的临床资料。结果:本组中转开腹6例,主动中转4例,被动中转2例,ELC成功率为96.58%,术后早期3例发生胆总管残留结石,行EST治疗,无死亡病例。结论:具有丰富腹腔镜经验的外科医生,急性胆囊炎伴结石嵌顿患者施行ELC是安全可行的,但须严格把握其中转开腹的指征并注重术前检查判断胆总管结石存在的可能性。

Objective： To summarize the time, feasibility and treatment experiences of the emergency laparoscopic cholecystectomy （ELC） for the patients of acute cholecystitis complicated with stone incarceration. Method：Clinical records of 175 cases of acute cholecystitis complicated with stone incarceration in recent five years treated by laparoscopic cholecystectomy were respectively reviewed. Results： 6 cases were conversion to laparotomy, 4 cases of them were active conversion to laparotomy, the other 2 cases were passive conversion to laparotomy, success rate of the emergency laparoscopic cholecystectomy（ELC）is 96.58 %, there were 3 cases occurrence residual stones in common bile duct and cleared by EST. There were no death cases. Conclusion： the emergency laparoscopic eholecystectomy （ELC） for the patients of acute cholecystitis＇complicated with stone incarceration is safe to the experienced surgeons. To grasp the indications strictly of conversion to laparotomy and judge the possibility of stones in common bile duct before laparoscopic cholecystectomy is important.