腹腔镜下治疗急性胆囊炎的临床体会

The management of laparoscopic cholecyscectomy in the treatment of acute cholecystitis

目的探讨腹腔镜胆囊切除术治疗急性胆囊炎的手术技巧,总结治疗经验,以更好的指导临床手术。方法对我院2014年1月~2015年1月为172例急性胆囊炎患者行腹腔镜胆囊切除术(laparoscopic cholecyscectomy,LC)的临床资料进行回顾性分析。均于发病72小时内施术,无明显肝功能损害及黄疸、无胰腺炎。经积极术前准备后行LC。结果 172例患者均治愈,术中出血15~200 ml,平均40 ml,手术时间30~120 min,平均55 min,术后住院2~7 d,平均3 d。术后毛细胆管漏5例,无术后出血、胆管损伤等并发症。结论选择合适的手术时机,充分的术前准备,根据术中的不同情况选择合理的手术方法,急性胆囊炎行LC安全,有效。

Objective To discuss the operative skills of laparoscopic cholecyscectomy( LC) in the treatment of acute cholecystitis. Methods The clinical data of 172 patients with acute cholecystitis underwent LC were retrospetively analyzed. All the operations were performed with 72 hours after onset,all patients without history of jaundice and pancreatitis,all patients were operated after admission. Results All the patients were cured. The average intraoperative bleeding was 40 ml( 10 ~ 200 ml),the mean time was 55 min( 30 ~ 120 min),the average postoperative hospitalization was 3 days( 2 ~ 7 d). Conclusions LC is safe and effective for acute cholecystits by the right opportunity of operation,ample preperative and careful operative manipulation.