三孔法腹腔镜胆囊切除术治疗急性胆囊炎

Three Holes Method Laparoscopic Cholecystectomy for Acute Cholecystitis

目的：探讨三孔法腹腔镜胆囊切除术治疗急性胆囊炎的应用价值。方法：2003年2月-2012年1月笔者所在医院对150例急性胆囊炎患者尝试三孔法腹腔镜胆囊切除，观察疗效。结果：145例患者顺利完成LC，2例患者因胆囊周围严重粘连，肝外胆管难以辨认，1例患者胆囊横结肠瘘，2例术中快速病检提示胆囊癌中转开腹。术后住院3-5d，无结肠，十二指肠及胃损伤，无胆管损伤及腹腔出血，剑突下切口感染5例，门诊换药治愈。结论：三孔法腹腔镜胆囊切除术治疗急性胆囊炎能迅速缓解患者剧烈腹痛及呕吐，终止患者痛苦，降低了发生胆囊穿孔、胆汁性腹膜炎及腹腔脓肿的风险，缩短了住院时间，降低了单病种的治疗费用，降低了并发症的发生及科室的医疗纠纷，减轻了医护人员的劳动强度及心理压力。

Objective ：To investigate three holes method laparoscopic cholecystectomy for acute cholecystitis in application value.Methods ：In our hospital from Feb 2003 to Jan 2012 150 cases of acute cholecystitis patients try three holes method laparoscopic cholecystectomy.Results ：145 patients successfully completed LC, 2 patients with gallbladder surrounding severe adhesions, extrahepatic bile duct illegible in 1 cases, gallbladder transverse colon fistula, 2 cases of rapid intraoperative pathological examination revealed gallbladder carcinoma laparotomy.The postoperative hospital stay of 3-5 days, without colonic, duodenal and gastric injury, no bile duct injury and intraperitoneal hemorrhage, subxiphoid incision infection in 5 cases, clinic medicine changing cured. Conclusion ：Three holes method laparoscopic cholecystectomy for acute cholecystitis can relieve the patient of severe abdominal pain and vomiting, termination of patient pain, reduces the incidence of perforation of the gallbladder, biliary peritonitis and peritoneal abscess risks, shorten hospitalization time, reduce the single disease cost of treatment, decrease the incidence of complications and the departments of medical disputes, reducing the labor intensity of medical staff and psychological pressure.