小切口不结扎胆囊动脉胆囊切除术

Cholecystectomy via Small Incision without Ligation of Cystic Artery

目的探讨小切口不结扎胆囊动脉胆囊切除术的临床意义。方法回顾性分析我院1998年3月～2012年2月期间行小切口不结扎胆囊动脉胆囊切除术的64例患者的临床资料,其中胆囊结石58例,胆囊息肉6例。切口长2.5～3.0 cm,平均(3.0±0.4)cm。使用电刀从胆囊底浆肌层游离至胆囊管,距胆总管约0.5～1 cm处结扎胆囊管,术毕均不置引流管。结果全组64例均顺利切除胆囊,手术出血甚少。手术时间25～60 min,平均(32.5±5.7)min。术后次日可下床活动及进流质饮食,有5例切口皮肤轻度红肿。术后住院2～7 d,平均(3.5±0.9)d,全部治愈出院。结论小切口不结扎胆囊动脉胆囊切除术具有操作简单、损伤小及恢复快等优点。

Objective To investigate the clinical significance of the cholecystectomy via small incision without ligation of cystic artery. Methods During the March 1998 to February 2012, the data of 64 cases underwent cholecystectomy via a small incision （length of 2.5 -3.0 cm, average 3.0 ± 0.4 cm） without ligation of cystic artery in our hospital were analyzed retrospectively. Out of them, 58 cases were cholecystolithiasis and 6 were gallbladder polypus. Serosa muscularis layer was dissected by electric knife from gallbladder end to the cystic duct, and the distance of the ligation cystic duct to bile duct was about 0.5 to 1 cm. Drainage tube was not placed in all cases after the operation. Results All 64 cases complete the eholecystectomy successfully via a small incision without cystic artery ligation. The operative duration was 25 to 60 minutes with an average of 32.5 ± 5.7 minutes. Out-of-bed activity and liquid diet was restored next day of the operation. Incisional skin was found slightly flare in 5 eases. The hospitalization after operation was 2 to 7 days with an average of 3.5±0.9 days and all were cured to discharge from the hospital. Conclusion Cholecystectomy via small incision without cystic artery ligation is a simple, mini-invasive and faster recovery operation.