腹腔镜手术治疗萎缩性胆囊炎合并糖尿病17例报告

Laparoscopic treatment of atrophic cholecystitis with diabetes mellitus: a report of 17 cases

目的:探讨萎缩性胆囊炎合并糖尿病的特点及腹腔镜治疗方法。方法:回顾分析2006年5月至2012年12月为17例萎缩性胆囊炎合并糖尿病患者行腹腔镜手术的临床资料,其中男5例,女12例,平均(61.3±8.5)岁,空腹血糖平均(10.7±2.5)mmol/L。结果:17例患者中2例中转开腹,手术时间平均(72±19)min,术中出血量平均(135.6±42.3)ml,术后平均住院(5.6±1.1)d,术后患者恢复顺利,均治愈出院。结论:萎缩性胆囊炎合并糖尿病患者行腹腔镜手术难度较大,风险较高,只要掌握围手术期处理,术前进行充分评估与准备,术中加强监测及熟练掌握手术技巧并做好中转开腹的准备,术后预防并发症,施行腹腔镜胆囊切除术是安全、可行的。

Objective：To investigate the characteristic of atrophic cholecystitis with diabetes and the laparoscopic treatment methods. Methods ：The clinical data of 17 patients of atrophic cholecystitis with diabetes who underwent laparoscopic surgery from May 2006 to Dec. 2012 were retrospectively analyzed. The patients included 5 males and 12 females, the mean age was （61.3 ＋ 8.5） years old, the average fasting blood glucose was （ 10.7 ＋ 2.5） mmol/L. Results：Two cases were converted to laparotomy, and the mean oper- ation time was （72 ＋ 19） rain,the mean blood loss was （135.6 ＋ 42.3 ） ml ,the mean postoperative hospital stay was （5.6 ＋-1.1 ） d. All patients were cured with uneventful postoperative recovery. Conclusions：The laparoscopic surgery for atrophic cholecystitis patients with diabetes mellitus is more difficult with higher risk. While, laparoscopic cholecystectomy is safe and feasible as long as the surgeons master the perioperative management, make full preoperative evaluation and preparation, enhance the intraoperative monitoring, make preparations for conversion to laparotomy, and prevent the postoperative complications.