[1]张晖,王先法①,周伟①,等.腹腔镜胆囊切除治疗急性胆囊炎279例[J].中国微创外科杂志,2008,08(4):370-371.
　Zhang Hui*,Wang Xianfa,Zhou Wei,et al.Laparoscopic Cholecystectomy for Acute Cholecystitis: Report of 279 Cases[J].Chinese Journal of Minimally Invasive Surgery,2008,08(4):370-371.
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腹腔镜胆囊切除治疗急性胆囊炎279例()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年4期
页码:
370-371
栏目:
出版日期:
2008-10-26

文章信息/Info

Title:
Laparoscopic Cholecystectomy for Acute Cholecystitis: Report of 279 Cases
作者:
张晖; 王先法①; 周伟①; 樊少华; 高勇; 赵辉; 徐清松; 王春泉
云南省楚雄州人民医院肝胆外科，楚雄675000
Author(s):
Zhang Hui*;  Wang Xianfa;  Zhou Wei;  et al.
*Department of Hepatobiliary Surgery, Chuxiong People’s Hospital of Yunnan Province, Chuxiong 675000, China
关键词:
急性胆囊炎; 腹腔镜胆囊切除术
Keywords:
Acute cholecystitis; Laparoscopic cholecystectomy
分类号:
R657.4
文献标志码:
A
摘要:
目的总结腹腔镜胆囊切除术（laparoscopic cholecystectomy, LC）治疗急性胆囊炎的经验。方法2000年1月~2007年9月，对急性胆囊炎279例采用常规四孔法和冲吸钝性解剖法行LC。结果254例成功完成LC；25例中转开腹，其中病程≤3 d的9例、病程＞3 d的16例，中转开腹原因：13例胆囊三角粘连致密，4例术中创面出血较多，4例术中发现胆总管结石，2例胆囊十二指肠瘘，1例胆囊结肠瘘，1例Mirizzi综合征。术中无胆管损伤，术后未发生腹腔出血、胆漏及肝下积液等并发症。279例术后随访5～24个月，平均12个月，无腹痛、黄疸等不适。结论腹腔镜手术治疗急性胆囊炎应严格掌握好手术时机和适应证，采用充分暴露胆囊三角区和精细化冲吸钝性解剖法有效避免术中出血及胆管损伤，并把握好中转开腹手术的时机。
Abstract:
ObjectiveTo summarize our clinical experience on laparoscopic cholecystectomy (LC) for acute cholecystitis．MethodsFrom January 2000 to September 2007, 279 patients with acute cholecystitis received LC using 4port technique and flushsuction blunt dissection in our hospital.ResultsThe LC was successfully completed in 254 cases, the other 25 patients (course of the disease ≤3 d in 9 cases, and ＞3 d in 16) were converted to open surgery because of massive adhesion at the Calot’s triangle (13 cases), severe wound hemorrhage (4), common bile duct stones (4), gallbladderduodenum fistula (2), gallbladdercolon fistula (1), or Mirizzi syndrome (1)．During the operation, no bile duct injury occurred. None of the patients had intraabdominal haemorrhage, biliary leak, or subhepatic abscess after the operation. The 279 patients were followed up for 5 to 24 months with a mean of 12 months, during which no patients complained of abdominal pain or jaundice.ConclusionsThe success of LC depends on early treatment and strict selection of patients. Intraoperative hemorrhage and bile duct injury can be avoided by sufficiently exposing the Calot’s triangle and using the technique of flushsuction blunt dissection. Conversion to open surgery is necessary when LC is difficult.

参考文献/References:

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备注/Memo

备注/Memo:
①（浙江大学医学院附属邵逸夫医院普外科，杭州310016）
更新日期/Last Update: 2013-10-22