腹腔镜在治疗急性结石嵌顿性胆囊炎中的应用

The Application of Laparoscopy for Acute Cholecystitis Complicated with Incarcerated Gallstones

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗急性结石嵌顿性胆囊炎的可行性。方法:总结分析2007年10月至2009年6月36例急性结石嵌顿性胆囊炎行腹腔镜胆囊切除术的经验体会,包括手术适应证及手术技巧等。结果:35例(97.2%)成功完成腹腔镜胆囊切除术,1例(2.8%)中转开腹,无胆管、肠管损伤,无术后出血及围手术期(术后30天)死亡等并发症,均获治愈。术后随访4月～23月无手术并发症。结论:在术者熟练的操作技巧,合理选择中转开腹时机的前提下,急性结石嵌顿性胆囊炎行腹腔镜胆囊切除术安全、可行。

Objective： To discuss the feasibility of acute cholecystitis complicated with incarcerated gallstones by laparoscopic cholecystectomy（LC）.Methods： The clinical data and experience of 36 cases of acute cholecystitis complicated with incarcerated gallstones performed by LC were analyzed retrospectively from October 2007 to June 2009,including operation indications,related operation skills and so on.Results： The LC was successfully completed in 35 cases（97.2%）,one case（2.8%） was converted to open surgery.No biliary or intestinal injury or postoperative bleeding or 30-day mortalities occurred in this series.No complication was found during a 4-23 months＇ follow-up.Conclusion： LC becomes safe and feasible for acute cholecystitis complicated with incarcerated gallstones as long as the operator has skilled technique and make the right decision on opportunity of conversion.