腹腔镜手术治疗急性结石性胆囊炎183例临床体会

Clinical Experience of laparoscopic surgery for acute calculus cholecystitis of 183 cases

目的:探讨急性结石性胆囊炎患者行腹腔镜胆囊切除术的术中处理及并发症的防治。方法:行LC治疗急性结石性胆囊炎患者183例,对其临床资料进行回顾性分析。结果:170例成功行胆囊切除术,4例行胆囊大部切除加胆囊黏膜电灼术,9例中转开腹,无死亡、无出血及胆管损伤。结论:急性结石性胆囊炎行LC是安全可行的。主张完善术前必要相关检查及准备后,尽早(最好在72小时内)实施手术,提高腹腔镜技术,适时中转开腹是防治并发症发生的关键。

Objective:To explore the intraoperative treatment and prevention and treatment of complications of acute cholecystitis patients treated by laparoscopic operation.Methods:We selected 183 cases of acute calculous cholecystitis with LC for the treatment from 2005 February to 2013 February,and the clinical data were retrospectively analyzed.Results:170 cases were successfully treated by laparoscopic cholecystectomy,4 cases underwent subtotal cholecystectomy and gallbladder mucosa electrocautery,9 cases were converted to laparotomy,and there were no death,no bleeding and bile duct injury.Conclusion:Acute calculous cholecystitis treated with LC is safe and feasible.We should improve the preoperative examination and necessary as soon as possible(preferably within 72 hours) to implement operation.Improving the laparoscopic technique and timely laparotomy is the key to the prevention of complications.