[1]卢朝德,蔡邢峰,汤卫国.肝硬化患者的腹腔镜胆囊切除术72例分析[J].中国微创外科杂志,2008,08(6):546-547.
　Lu Chaode,Cai Xingfeng,Tang Weiguo..Laparoscopic Cholecystectomy for Hepatic Cirrhosis: Report of 72 Cases[J].Chinese Journal of Minimally Invasive Surgery,2008,08(6):546-547.
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肝硬化患者的腹腔镜胆囊切除术72例分析()
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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6期
页码:
546-547
栏目:
出版日期:
2008-10-31

文章信息/Info

Title:
Laparoscopic Cholecystectomy for Hepatic Cirrhosis: Report of 72 Cases
作者:
卢朝德; 蔡邢峰; 汤卫国
南通市第三人民医院普外科，南通226006
Author(s):
Lu Chaode;  Cai Xingfeng;  Tang Weiguo.
Department of General Surgery, Third People’s Hospital of Nantong, Nantong 226006, China
关键词:
肝硬化; 腹腔镜胆囊切除术; 胆囊结石
Keywords:
Hepatic cirrhosis;  Laparoscopic cholecystectomy;  Cholecystolithiasis
分类号:
R657.4;R575.2
文献标志码:
A
摘要:
目的探讨肝硬化患者施行腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）的安全性。 方法回顾性分析2002年7月～2007年3月72例ChildPugh A、B级肝硬化行LC的临床资料。全麻，四孔法，气腹压力8～12 mm Hg。结果71例完成LC(顺行切除67例，逆行切除4例)，其中6例行胆囊大部分切除；因胆囊三角区致密粘连中转开腹1例。手术时间35～105 min，平均51 min；出血量5～60 ml，平均12 ml；术后住院时间3～11 d，平均5.6 d。术后出现腹水7例，穿刺孔出血1例。71例随访3～18个月，平均12个月，临床症状消失，无结石复发及残留。结论在充分做好术前准备，恰当的术中及术后处理的情况下，肝硬化病人行LC是安全的，对于肝功能A、B级须切除胆囊者应首选LC。
Abstract:
ObjectiveTo evaluate the safety of laparoscopic cholecystectomy (LC) for patients with hepatic cirrhosis.MethodsWe retrospectively analyzed the clinical data of 72 patients with hepatic cirrhosis (ChildPugh’s grads A or B). The patients received LC between July 2002 and March 2007. Under general anesthesia, the operation was preformed with four trocars and an intraabdominal pressure of 8 to 12 mm Hg.ResultsLC was completed in 71 of the patients (antegrade in 67 and retrograde in 4), 6 of them received subtotal cholecystectomy. One patient was converted to open procedure because of dense adhesion at the Calot triangle. The operation time was 35 to 105 minutes (mean, 51 minutes); blood loss ranged from 5 to 60 ml with a mean of 12 ml. The patients were discharged 3 to 11 days (mean, 5.6 days) after the operation and were followed up for 3 to 18 months (mean, 12 months). After the operation, 7 patients developed ascites, and 1 had hemorrhage at the puncture site. During the followup, all patients were free of biliary symptoms, no residual or recurrent liver stone was found.ConclusionsLC is safe for patients with liver cirrhosis, and should be the first choice for ChildPugh’s grads A or B patients. Proper preoperative preparation and intra and postoperative treatments are critical for the surgical outcomes.

参考文献/References:

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更新日期/Last Update: 2013-10-22