腹腔镜胆囊切除术治疗急性胆囊炎

The treatment effect of laparoscopic cholecystectomy on acute cholecystitis

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗急性胆囊炎的疗效及手术价值。方法:回顾分析为98例急性胆囊炎患者行LC的临床资料,其中男65例,女33例,发病时间9 h^5 d,均采用四孔法施术。结果:89例成功完成LC,9例中转开腹,中转率9.2%。手术时间25~150 min,无并发症发生,术后愈合良好,患者均痊愈出院。术后病理证实为急性单纯性胆囊炎55例、化脓性胆囊炎32例、坏疽性胆囊炎11例。85例获得随访,随访3~36个月,无严重并发症发生。结论:LC具有患者创伤小、疤痕小、术后康复快等优点,对于胆囊良性病变优势较大。急性胆囊炎患者应积极选择手术治疗,尤其逆行切除术,手术安全、可靠,适于发病72 h内的患者;对于发作时间较长的患者,也应根据患者实际情况及术者经验综合评估、分析。

Objective： To research the therapeutic effect and operative value of laparoscopic cholecystectomy in the treatment of acute cholecystitis. Methods： The clinical data of 98 patients who suffered from acute cholecystitis and underwent laparoscopic cholecystectomy were retrospectively analyzed. There were 65 males and 33 females,time of onset was 9 h-5 d. 4-port method was used. Results：Nine patients were converted to laparotomy,the conversion rate was 9. 2%. The operative time was 25-150 min. No complications occurred,all patients recovered well and were discharged from hospital. The postoperative pathological results were 55 cases of acute simple cholecystitis,32 cases of purulent cholecystitis and 11 cases of gangrenous cholecystitis. 85 patients were followed up for 3-36 months,no serious complications were found. Conclusions： Laparoscopic cholecystectomy has advantages for benign gallbladder diseases,such as little trauma,small scar and quick recovery. Patients with acute cholecystitis should positively choose operation,especially retrograde resection,the operation is safe and reliable,suitable for patients with onset≤72 h. For patients with longer time of onset,surgeons should comprehensively evaluate and analyze according to patients＇ reality and operators＇ experience.