循A-B-D路径的腹腔镜胆囊切除术在急性化脓或坏疽性胆囊炎病人中的应用

The application of laparoscopic cholecystectomy following the A-B-D approach in acute suppurative and gangrenous cholecystitis

目的探讨循A-B-D路径的腹腔镜胆囊切除术在急性化脓或坏疽性胆囊炎手术中的应用价值。方法2019年9月~2020年12月间收治的急性化脓和坏疽性胆囊炎病人45例,均采用循A-B-D路径的腹腔镜胆囊切除术,总结其安全性和有效性。结果45例病人中除1例中转开腹外,其余44例均顺利完成手术。全组平均手术时间(100.3±38.6)分钟、术后住院时间(4.3±2.2)天。全部病例均无胆道损伤、术后出血等严重并发症发生。结论循A-B-D路径的腹腔镜胆囊切除术是一种优化手术路径的手术思维模式,安全有效。

Objective To investigate the clinical value of laparoscopic cholecystectomy following A-B-D approach applied in the operation of acute suppurative or gangrenous cholecystitis.Methods We seeked out the Patients diagnosed as acute suppurative or gangrenous cholecystitis and treated by laparoscopic cholecystectomy following the A-B-D approach in People’s Hospital of Leshan from Sep.2019 to Dec.2020,and we analyzed clinical data of the patients retrospectively to investigate the safety and efficacy of the A-B-D approach LC procedure.Results The A-B-D approach LC procedure was completed successfully in 44 cases,only 1 case was converted to laparotomy.The mean operation time was(100.3±38.6)min and postoperative hospitalization time was(4.3±2.2)d.No serious complications such as biliary tract injury and postoperative bleeding occurred in all cases.Conclusions The laparoscopic cholecystectomy following the A-B-D approach is a optimized surgical procedure and our clinical practice preliminarily confirmed the safety and efficacy of the procedure.