肝硬变病人腹腔镜胆囊切除术92例临床分析

Laparoscopic cholecystectomy for cirrhotic patients:a clinical analysis of 92 cases.

目的 探讨肝硬变病人腹腔镜胆囊切除的手术适应证和某些手术技术细节。方法 对 92例肝功能ChildA、B级的症状性胆囊结石病人进行了气腹腹腔镜胆囊切除术。结果 所有病人术后经过平稳 ,无胆道损伤及术后再出血。因胆囊嵌顿结石、三角区致密粘连中转开腹 2例 ,1例于穿刺时气腹针损伤肿大脾脏 ,但未造成严重后果。结论 对于正确选择的病人 。

Objective To discuss the indications for laparoscopic cholecystectomy(LC)in cirrhotic patients and the technical details in the procedure.Methods 92 cirrhotic patients with symptomatic gallstone classified as A or B by Child classification underwent pneumoperitoneum LC.Results All patients recovered uneventfully.No bile duct injury or postoperative haemorrhage was observed.2 cases were converted associated with impacted stone or dense adhesion presented in the Calot's triangle.Spleen injury related to acupuncture for pneumoperitoneum in 1 case was noted,however,no serious sequelae occurred.Conclusion For reasonably selected cirrhotic patients with gallstone,LC is good choice of treatment for symptomatic gallstone.