胆囊管逆行分离法在萎缩性胆囊炎LC中的应用

Retrograde dissection of the cystic duct in laparoscopic cholecystectomy for atrophic cholecystitis

目的：探讨胆囊管逆行分离法在腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）治疗萎缩性胆囊炎中的价值及可行性。方法：回顾性分析我院2007~2009年腹腔镜胆囊切除术治疗萎缩性胆囊炎48例,采用胆囊管逆行分离法处理胆囊三角,切除胆囊。结果：47例患者成功完成腹腔镜胆囊切除术,1例因胆囊三角解剖不清,胆囊动脉牵拉出血,止血无效而中转开腹。结论：胆囊管逆行分离法腹腔镜胆囊切除术治疗萎缩性胆囊炎安全有效,但仍应遵循手术安全、适时中转的原则。

Objective：To evaluate the feasibility and significance of retrograde dissection of the cystic duct in laparoscopic cholecystectomy（LC） for treatment of atrophic cholecystitis.Methods： The clinical data were reviewed in 48 patients with atrophic cholecystitis undergone LC with retrograde dissection of the gallbladder.Results：Forty-seven patients were successfully undergone the dissection of the gallbladder through LC,but one case was referred to laparotomy due to dark anatomy of Calot′s triangle,as a result of bleeding and failure of hemostasis.Conclusion： Retrograde separation of cystic duct in LC appears safe and effective in treatment of atrophic cholecystitis,and yet,some principles of surgery should be emphasized and timely reference is necessary.