[1]宫轲.胆囊结石伴急性胰腺炎的腹腔镜胆囊切除术[J].中国微创外科杂志,2006,06(4):294-295.
　GongKe..Laparoscopic cholecystectomy for acute pancreatitis accompanying gallstones[J].Chinese Journal of Minimally Invasive Surgery,2006,06(4):294-295.
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胆囊结石伴急性胰腺炎的腹腔镜胆囊切除术()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
06
期数:
2006年4期
页码:
294-295
栏目:
出版日期:
2006-04-20

文章信息/Info

Title:
Laparoscopic cholecystectomy for acute pancreatitis accompanying gallstones　
作者:
宫轲
北京世纪坛医院普外科,北京,100038
Author(s):
GongKe.
Department of General Surgery, Beijing Shijitan Hospital, Beijing 100038, China
关键词:
胆囊结石; 急性胰腺炎; 腹腔镜胆囊切除术
Keywords:
Gallstone; 　Acute pancreatitis; 　Laparoscopic cholecystectomy
分类号:
R657.4
文献标志码:
A
摘要:
目的探讨胆囊结石伴急性胰腺炎实施腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的可行性及手术时机.方法回顾性分析我院1999年1月～2003年8月行LC治疗胆囊结石伴急性胰腺炎21例的临床资料.结果21例均在急性胰腺炎发作后20～40 d,血、尿淀粉酶正常15 d后,成功实施LC,9例放置腹腔引流管.术后19例恢复顺利,当日或次日下床活动,12 h后进食,术后24～72 h拔除腹腔引流管,无并发症.2例术后3 d又发作急性胰腺炎,经保守治疗后症状缓解.住院4～20 d,平均7 d.21例随访6个月～5年,平均19个月,均无复发.结论对胆囊结石伴急性胰腺炎患者在急性胰腺炎发作后20～40 d,如能慎重选择病例,做好必要的围手术处理,术中仔细操作,术后适当引流,实施LC是安全的.
Abstract:
Objective　To investigate the feasibility and timing of laparoscopic cholecystectomy (LC) for the treatment of acute pancreatitis accompanying gallstones.　M ethods　A retrospective analysiswasmade on clinical data of21 patientswith acute pancreatitis accompanying gallstones treated by LC between January 1999 and August2003 in this hospita.l　Results　The LC was performed 20~40 days after the onsetofpancreatitis and 15 days after the recovery of serum and urinary amylase levels. An abdominal drainage tubewas placed in 9 patients. Postoperative recoverywas uneventful in 19 patients, who gotoutofbed on the surgery day or on the firstpostoperative day and began to take food 12 hours after operation, with the abdominaldrainage tube removed 24~72 hours postoperatively and no complications encountered. Recurrence of acute pancreatitis happened in 2 patients on the 3 postoperative days and was relieved from symptoms with conservative treatment. The duration of postoperative hospital stay was 4~20 days (mean, 7 days). Follow-up checkups in the 21 patients for6 months ~ 5 years (mean, 19 months) found no recurrence.　Conclusions　 Laparoscopic cholecystectomy is feasible and safe for patientswith acute pancreatitis accompanying gallstones in the period of 20~40 days after the onset of pancreatitis. Careful patient selection, proper peri-operative treatment, strict adherence to techniques, and use of postoperative drainage are considered essentia.l

参考文献/References:

[1]中华医学会外科学分会胰腺外科学组.重症急性胰腺炎诊治草案.中华普通外科杂志,2001,16(11):699-700.
[2]宫轲.腹腔镜时代的胰腺外科.中国微创外科杂志,2005,5:517-518.
[3]宫轲.老年胆囊结石患者的腹腔镜胆囊切除术.中国微创外科杂志,2001,1:29-30.
[4]Bingener J,Richards ML,Schwesinger WH,et al.Laparoscopic cholecystectomy for elderly patients:gold standard for golden years?Arch Surg,2003,138 (5):531-536.
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更新日期/Last Update: 2014-01-27