急性胆囊炎腹腔镜切除术中腹腔引流的指征及其评价

Indication and Role of Intraperitoneal Drainage on Laparoscopic Cholecystectomy for Acute Cholecytitis

目的 探讨急性胆囊炎腹腔镜切除术 (LC)中腹腔引流的放置指征及其作用。方法 回顾性分析4 2 6例急性胆囊炎LC的病历资料及腹腔引流的应用情况。结果 4 2 6例LC中 ,14 8例放置腹腔引流 (引流组 ) ,2 78例未放置腹腔引流 (非引流组 )。引流组有 12例术后并发胆漏 ,其中 1例于术后早期经再手术证实为胆囊管钛夹脱落所致 ,其余 11例均经充分引流而治愈。非引流组术后有 3例并发腹腔积液 ,1例并发腹腔脓肿 ,均在LC 1周后经再手术引流治愈。结论 腹腔引流可及早发现甚至治愈急性胆囊炎LC的并发症 ;适当放宽其指征是必要的。

Objective: To discussion the indication and role of Intraperitoneal Drainage(ID)on Laparoscopic Cholecystectomy(LC) for Acute Cholecytitis(AC). Methods: Four hundred and twenty-six cases of LC for AC with and without ID were analysed retrospectively.Results: Among the 426 cases,there was 148 cases with ID(group ID),the others without ID (group non-ID). All the 12 cases complicated with bile leak in group ID were cured by drainage,except one case of reoperation. However,in group non-ID,3 cases of intraabdoninal collection,and one case of intraperitoneal abscess underwent reoperation one week after the first operation.Conclusions: It is necessary to widen the indication of ID on LC for AC. ID can expose,even cure,postoperative complications in time.