结石嵌顿性胆囊炎腹腔镜手术的临床分析

Clinical Analysis of Laparoscopic Cholecystectomy for Incarcerated Calculi in Gallbladder

目的探讨不同病理状态下结石嵌顿性胆囊炎腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的临床应用价值。方法回顾性分析2001年1月-2009年10月期间172例结石嵌顿性胆囊炎患者行腹腔镜手术的临床资料。结果腹腔镜手术成功164例,成功率为95.35%,中转开腹8例,中转率为4.65%。术中出血1例,术后并发胆漏1例,胆管残余结石1例,切口感染1例,并发症发生率为2.33%(4/172),无胆管损伤,无死亡。结论LC治疗结石嵌顿性胆囊炎安全、可行,但必须严格掌握手术适应证、时机和技巧。适时中转手术是提高手术成功率、降低并发症的关键。

Objective To explore the clinical value of laparoscopic cholecystectomy（LC）on incarcerated calculus in gallbladder in various pathological conditions.Methods The clinical data of 172 patients who underwent LC from January 2001 to October 2009 were analyzed retrospectively.Results In the series,operations of 164 cases succeeded,the achievement ratio was 95.35%,8 cases got conversion into open operation,and the ratio was 4.65%.During operation,1 case had hemorrhage,after operation 1 case had biliary leakage,1 case had residual calculi in bile duct,1 case had incision infection,and the incidence of complications was 2.33%（4/172）.There was no death or injury to bile duct.Conclusion LC is feasible and safe in patients with incarceratea calculus.The keys to successful operation and fewer complications are operation indication,opportunity,technique and prompt conversion into open operation timely.