腹腔镜手术治疗血吸虫病肝纤维化门静脉高压合并胆囊结石

Laparoscopic surgical treatment for schistosomiasis liver fibrosis portal hypertension combined with calculous cholecystitis

目的观察腹腔镜胆囊切除术(LC)治疗血吸虫病肝纤维化门静脉高压综合征(门脉高压症)合并胆囊结石的疗效。方法分析2006年6月-2013年6月采用LC治疗的196例血吸虫病肝纤维化门脉高压症合并胆囊结石患者的临床资料。结果本组血吸虫病肝纤维化门脉高压症合并慢性结石性胆囊炎154例,合并急性结石性胆囊炎42例,Child A级160例,B级36例。189例完成LC;7例中转开腹,其中腹腔、胆囊周围黏连及胆囊三角解剖不清3例,术中出血,镜下止血困难4例。196例全部治愈。结论 LC治疗血吸虫病肝纤维化门脉高压症合并胆囊结石疗效良好。

Objective To evaluate the curative effect of laparoscopic cholecystectomy（LC）in the treatment of schistosomia-sis liver fibrosis portal hypertension combined with calculous cholecystitis. Methods The clinical data of 196 cases of schistoso-miasis liver fibrosis portal hypertension combined with calculous cholecystitis（Child A 160 cases,Child B 36 cases）treated with LC were collected and analyzed from June 2006 to June 2013. Results Among the 196 cases,there were 154 cases of schistoso-miasis liver fibrosis portal hypertension combined with chronic calculous cholecystitis,and 42 cases of schistosomiasis liver fibro-sis portal hypertension combined with acute calculous cholecystitis. Totally 189 patients underwent LC successfully,but 7 were transited to the general operation because of LC failure,including 3 cases of adhesion around gallbladder and ambiguous dissec-tion of gallbladder triangle,and 4 cases of intraoperative bleeding and the bleeding was difficult to stop under the laparoscopy. All the 196 patients were cured. Conclusion LC is effective and safe in the treatment of schistosomiasis liver fibrosis portal hyperten-sion combined with calculous cholecystitis.