保胆取石术后再次行腹腔镜胆囊切除术的临床分析

Clinical analysis of laparoscopic cholecystectomy after gallbladder-preserved lithotomy

目的探讨保胆取石术后再次行腹腔镜胆囊切除术的原因及方法。方法回顾性分析我院近5年收治的16例保胆取石术后行胆囊切除术患者的临床资料,分析再次手术的原因,总结手术方法和特点。结果保胆取石术后再次手术的原因分别为:胆囊结石复发11例,胆囊萎缩伴胆囊炎3例,胆囊结石伴胆总管结石1例,胆囊腺肌症1例。16例中,15例经LC手术治愈,1例中转开腹。结论保胆取石术后再次手术的主要原因为结石复发,再次手术选择腹腔镜下完成是安全可行的。

Objective To discuss the causes and methods of laparoscopic cholecystectomy （LC） after gallbladder-preserved lithotomy. Methods A retrospective analysis was made in the clinical data of 16 patients who were treated by LC after gallbladder- preserved lithotomy in the department in the recent 5 years. The causes of the reoperation were analyzed, and the operative methods and characteristics were summarized. Results The causes for reoperation after the lithotomy included the relapse of cholecystolithiasis in 11 cases, atrophy of gallbladder accompanied by cholecystitis in 3 cases, cholecystolithiasis accompanied by common bile duct stone in 1 case, and adenomyomatosis of gallbladder in 1 case. Among the 16 cases, 15 ones were cured by LC, and 1 case was treated by open cholecystectomy. Conclusion The relapse of calculus is the major cause for the reoperation after the gallbladder-preserved lithotomy. The reoperation under laparoscopy is safe and feasible.