摘要
目的:探讨急性结石性胆囊炎行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)手术时机的选择及术中并发症的预防。方法:回顾分析2008年1月至2011年6月为127例急性结石性胆囊炎患者施行LC的临床资料。结果:125例顺利完成LC2,例中转开腹。术后继发胆管结石3例,均于术后3～5 d行经内镜十二指肠乳头括约肌切开取石术。术后发生胆漏1例,于术后24 h立即行开腹手术处理。余者均无并发症发生。结论:急性结石性胆囊炎一旦明确诊断,不论病程长短,应尽早施行LC,最佳手术时机为72 h内;术中操作困难及时中转开腹。有效减少或避免急性结石性胆囊炎LC手术并发症的关键是严格遵循LC操作原则;此外,术中耐心、细致地解剖是另一重要保证。
Objective：To investigate the choice of operative opportunity and prevention of intraoperative complications in lapa- roscopic cholecystectomy （LC） for acute calculous cholecystitis. Methods：The clinical data of 127 patients who suffered from acute calculous cholecystitis and underwent LC were retrospectively analyzed. Results：LC was successfully performed in 125 cases, 2 cases were converted to laparotomy. Secondary calculus of bile duct occurred in 3 patients, who underwent endoscopic sphincterotomy 3-5 days after LC. Bile leakage was found in 1 patient, who was performed laparotomy 24 h after LC. No other complications were found. Conclu- sions ： Once the diagnosis of acute calculous cholecystitis is definite, LC should be performed as soon as possible whatever the course of disease is,the operative procedure should be applied in 3 days. Conversion to laparotomy is necessary when LC is difficult. Surgeon strictly following LC operative principle and intraoperative careful anatomy are very important for decreasing and aw）iding the LC com- plications.
出处
《腹腔镜外科杂志》
2011年第11期858-860,共3页
Journal of Laparoscopic Surgery
关键词
胆囊炎
急性
胆囊结石病
胆囊切除术
腹腔镜
Cholecystitis, acute
Cholecystolithiasis
Cholecystectomy, laparoscopic
