腹腔镜下复杂性胆囊炎的手术方式探讨

Laparoscopic management for complicated cholecystitis

目的：通过研究腹腔镜下复杂性胆囊炎的手术方式，来探讨腹腔镜胆囊次全切除术（LSC）的可行性、安全性及手术的操作技巧。方法回顾分析我院164例行腹腔镜手术的复杂性胆囊炎患者，观察分析LC和LSC两组患者的围手术期情况。结果 LSC组急诊手术的比例明显高于LC组；LSC组手术时间、术中出血量、中转开腹例数、术后引流量及住院时间则明显低于LC组（P＜0．05）。LSC组胆管损伤发生率明显低于LC组（P＜0．05）。结论采用LSC治疗复杂性胆囊炎可以降低手术风险，防止胆道损伤、大出血等严重并发症的发生，是一个安全、有效、可行的手术方式。

Objective To explore the feasibility,security and skills of laparoscopic subtotal cholecystectomy（LSC）by studying laparoscopic management for complicated cholecystitis.Methods A totalof 164 cases of complicated cholecystitis were retrospectively analyzed for laparoscopic operation in ourhospital.Perioperative situations of laparoscopic cholecystectomy（LC）group and LSC group were observedfor analysis.Results In the LSC group,percentage of emergency operation was significantly increasedcompared with that of the LC group.Operative time,blood loss,ratio of conversion to open cholecystectomy（OC）,postoperative drainage volume and hospital stay in the LSC group were significantly decreased compared with those in the LC group（P 〈0.05）.For postoperative complications,the incidence of biliary ductinjury in the LSC group was also lower than that in the LC group（P 〈0.05）.Conclusion For complicated cholecystitis,LSC can reduce operative risk and prevent severe complications such as biliary duct injuryand hemorrhea,which is a safe,effective and feasible surgical procedure.