腹腔镜胆囊切除术治疗急性胆囊炎合并胆囊结石体会

Analysis of Laparoscopic Cholecystectomy in the Treatment of Acute Cholecystitis Combine with Gallstone

目的探讨急性胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术(laparoscopic cholecystect omy,LC)的术式、术中处理,并发症的防治。方法回顾性分析我院2005年2月至2009年2月为54例急性胆囊炎合并胆囊结石患者行LC的临床资料。结果50例成功完成LC,腹腔镜完整胆囊切除术44例,胆囊大部切除术加残余胆囊黏膜电灼破坏术6例。因Calot三角致密粘连,解剖不清,转开腹3例,因胆囊坏疽中转开腹1例。手术时间40～130min,平均60min。术后住院5～10d,平均7.2d。术后无严重并发症发生。结论急性胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术是安全有效的。

Objective To explore the operation methods,intraoperative treatment,measures for prevention and treatment of compli-cations of laparoscopic cholecystectomy（LC）in the treatment of acute cholecystitis combine with gallstone.Methods The clinical data of 54 patients with acute cholecystitis combine with gallstone undergoing LC from January 2003 to January 2008 was retrospectively analyzed.Results LC was successfully performed on 50 patients,total lapar oscopic cholecystectomy in 44 cases and subtotal laparoscopc cholecystectomy with cholecystomucoclasis of remnant gallbladder in 6 cases,and 3 cases were converted to open surgery for disturbed anatomy and severe adhesion in the region of the Calot＇s triangle,1 case was converted to open surgery for Gangrenous Cholecystectomy. The operative time was 40--130min（average 60min）,and the hospitalization was 5--10 days（average 7.2d）.No serious post operative complications occurred. Conclusion LC is safe and effective for patients with acute cholecystitis combine with gallstone.