腹腔镜手术治疗颈部结石嵌顿性急性胆囊炎88例临床分析

Clinical analysis of 88 cases underwent laparoscopic cholecystectomy with calculus in neck and duct of gallbladder

目的:探讨颈部结石嵌顿性急性胆囊炎患者行腹腔镜胆囊切除术的特点及手术技巧。方法:回顾分析88例胆囊颈部结石嵌顿性急性胆囊炎患者行腹腔镜手术的临床资料。结果:87例均顺利完成腹腔镜胆囊切除术,其中2例M irizzi综合征Ⅰ型行腹腔镜胆囊部分切除术,1例合并胆囊十二指肠瘘中转开腹。结论:颈部结石嵌顿性急性胆囊炎患者行腹腔镜手术安全可行,术中如胆囊颈部粘连致密无法解剖,胆囊与邻近脏器内瘘形成应及时中转开腹。

Objective：To analyze the characteristics and experiences of laparoscopic cholecystectomy in patients with calculus in neck and duct of gallbladder, Methods ： The clinical date of 88 cases with calculus in neck and duct of gallbladder underwent laparoscopic cholecystectomy were retrospectively analyzed. Results ： Eighty-seven cases had been performed LC successfully, one case was converted to open surgery because of gallbladder-duodenum fistula. Conclusions： Laparoscopic cholecystectomy is a safe treatment to patients with calculus in neck and duct of gallbladder. Open surgery should be advocated when there is difficulty or fistula formation between gallbladder and organs nearby.