[1]嵇武,李令堂,丁凯,等.腹腔镜胆囊次全切除术168例报告[J].中国微创外科杂志,2008,08(4):372-374.
　Ji Wu,Li Lingtang,Ding Kai,et al.Laparoscopic Subtotal Cholecystectomy: Report of 168 Cases[J].Chinese Journal of Minimally Invasive Surgery,2008,08(4):372-374.
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腹腔镜胆囊次全切除术168例报告()
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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:
372-374
栏目:
出版日期:
2008-10-26

文章信息/Info

Title:
Laparoscopic Subtotal Cholecystectomy: Report of 168 Cases
作者:
嵇武; 李令堂; 丁凯; 汪志明; 王丹; 彭丽娜
南京军区南京总医院全军普通外科研究所，南京210002
Author(s):
Ji Wu;  Li Lingtang;  Ding Kai;  et al.
Research Institute of General Surgery of PLA, Nanjing General Hospital of Nanjing Command Area, Nanjing 210002, China
关键词:
腹腔镜胆囊切除术; 胆囊炎; 腹腔镜胆囊大部切除术
Keywords:
Laparoscopic cholecystectomy; Cholecystitis; Laparoscopic subtotal cholecystectomy
分类号:
R657.4
文献标志码:
A
摘要:
目的探讨腹腔镜胆囊次全切除术（laparoscopic subtotal cholecystectomy，LSC）的可行性和技术特点。方法对168例因各种原因无法完成腹腔镜胆囊切除术的患者转行LSC，方法包括从分离Calot三角开始和从切开Hartmann袋减压、取石开始。结果5例中转开腹行胆囊次全切除术； 122例在胆囊管和胆囊动脉夹闭后行胆囊大部切除；41例先在Hartmann袋处切开胆囊，然后寻找、夹闭胆囊管和胆囊动脉或缝扎胆囊颈部，再行胆囊大部切除。手术时间（65.5±15.2）min，术中出血量（71.5±15.5）ml，术后恢复进食时间（20.4±6.3）h，出现局部并发症7例（4.2%），术后住院时间（4.2±2.6）d。105例随访（25.5±6.5）月，消化不良5例，右肩牵涉痛3例，右上腹部不适9例。结论对于复杂胆囊炎，LSC是可行的，术者要熟练掌握LSC的技术特点，正确处理好出血和胆漏是LSC成功的关键。
Abstract:
ObjectiveTo investigate the feasibility and technique of laparoscopic subtotal cholecystectomy (LSC). MethodsTotally 168 patients were converted to LSC because of failure in laparoscopic cholecystectomy (LC). During the LSC, the Calot’s triangle was separated and then the Hartmann’s pouch was incised to decreased the intracystic pressure for the removal of the stones. ResultsAmong the cases, 5 patients were converted to open surgery for subtotal resection of the gallbladder. LSC was completed after clipping the cystic duct and artery in 122 patients; in the other 41 cases, the gallbladder was cut at the Hartmann’s pouch to clip the bile duct and artery or suture the neck of the gallbladder, and then LSC was performed. The median operation time was (65.5±15.2) min, and the intraoperative blood loss was (71.5±15.5) ml. The time to resume the diet was (20.4±6.3) h postoperation. After the operation, 7 patients developed local complications (4.2%), and the mean postoperative hospital stay was (4.2±2.6) d. Of the patients, 105 were followed up for (25.5±6.5) months, during this period, 5 patients had dyspepsia, 3 had right shoulder pain, and 9 had right hypochondrium pain.ConclusionsLSC is feasible for patients with complicated cholecystitis. It is important to control the perioperative hemorrhage and bile leakage.

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更新日期/Last Update: 2013-10-22