结石性萎缩性胆囊炎的腹腔镜手术治疗

Laparoscopic operation for calculous atrophic cholecystitis

目的 总结腹腔镜下结石性萎缩性胆囊炎处理的经验。 方法 回顾分析 1997年～ 2 0 0 0年 ,5 6例结石性萎缩性胆囊炎行腹腔镜胆囊切除术。 结果 腹腔镜下胆囊切除 5 2例 ,其中顺行切除39例 ,逆行切除 13例 ;中转开腹行胆囊切除 4例 ,其中 3例胆总管切开探查T管引流。腹腔置引流管 8例。 5 6例均治愈 ,2例出现胆漏 ,经置管保守治愈。 结论 解剖清晰、认准变形的壶腹与胆囊管交界部位、严格掌握腹腔镜胆囊切除术的指征和开腹时机、预防性放置引流管是结石性萎缩性胆囊炎腹腔镜胆囊切除成功的关键。

Objective To summarize our experience in the management of calculous atrophic cholecystitis by laparoscopic choleycystectomy(LC). Methods 56 cases of calculous atrophic cholecystitis treated by LC from 1997 to 2000 were analyzed retrospectively. Results 52 cases treated by LC including antergrade resection in 39 ones, retrograde resection in 13 ones were successfully completed. 4 patients were converted to open cholecystectomy, 3 of whom underwent choledochotomy and T-tube drainage. There was abdominal cavity drainage in 8 cases. 56 patients were an cured. Bile leakage occurred in 2 cases, and the patients were cured by conservative treatment. Conclusions It's key point to perform LC successfully for patients with calculous atrophic cholecystitis by getting well known of the junction site of ampulla and cystic duct, selecting indications of LC strictly, converting to open operation as necessary and putting preventive drainage- tube.