胆囊结石颈部嵌顿者开腹与腹腔镜胆囊切除术比较

Gallstone impacted by laparotomy compared with laparoscopic cholecystectomy

目的比较开腹与腹腔镜胆囊切除术处理胆囊结石颈部嵌顿者的利弊。方法对2006年7月～2010年7月收住我科的265例胆囊结石颈部嵌顿、急性胆囊炎患者两种手术方式进行回顾性分析。比较开腹手术与腹腔镜胆囊切除处理胆囊结石颈部嵌顿者的手术时间、术中出血量、术后3d血浆管引流量、术后住院天数和术后并发症的发生率,分析两种手术方式的可行性。结果 200例成功施行LC1,2例中转开腹5,3例行开腹手术2,例术后发生胆瘘,无死亡患者,全部患者均痊愈出院。结论随着腔镜技术的不断提高,对于胆囊结石颈部嵌顿者,LC可作为首选,术后恢复快、痛苦小、并发症少。

Objective To compare open surgery with laparoscopic cholecystectomy in treatment of gallstone incarcerated are pros and cons of the neck.Methods 2006.07～2010.07 admitted to our department of 265 cases of gallstone incarcerated neck,two surgical patients with acute cholecystitis were reviewed retrospectively.Comparison of open surgery and laparoscopic treatment of gallstone incarcerated persons neck operation time,blood loss,after three days of plasma tube drainage,postoperative hospital stay and postoperative complication rate of 2 the feasibility of different surgical methods.Results 200 patients with successful implementation of the LC,12 were converted to laparotomy,53 regular open surgery,two cases of biliary fistula,no deaths,all patients were cured.Conclusion With the continuous improvement of laparoscopic techniques for gallbladder neck incarcerated persons,LC can be used as first choice,rapid postoperative recovery,less pain and fewer complications.