腹腔镜胆囊切除术治疗急性胆囊炎的疗效分析(附103例报告)

目的:探讨急性胆囊炎患者行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的可行性及临床价值。方法:回顾分析2006年1月至2008年6月我院为103例急性胆囊炎患者行LC的临床资料。结果:100例成功完成LC;3例中转开腹(2.91%),均为发病72h后行LC,其中1例Calot三角区严重水肿、粘连致密,无法辨清胆管关系,Mirizzi综合征及胆囊十二指肠瘘各1例。手术时间30～140min,平均80min。均痊愈出院,随访6～60个月,平均28.5个月,无并发症发生及死亡病例。结论:急性胆囊炎行LC,难度大,但只要合理选择患者,把握手术时机并注重手术技巧,急性胆囊炎患者行LC是安全可靠的。

The analysis of therapeutic effect of laparoscopic cholecystectomy for acute cholecystitis:with a report of 103 cases

Objective:To investigate the feasibility and the clinical value of laparoscopic cholecystectomy(LC) for acute cholecystitis.Methods:The clinical data of 103 cases with acute cholecystitis underwent laparoscopic cholecystectomy in our hospital between Jan.2006 and Jun.2008 were retrospectively analyzed.Results:Operations for 100 cases were successfully accomplished,and conversion to open surgery was required in 3 cases(2.91%) who were treated by LC more than 72 hours after cholelithiasis had attacked.The main causes of conversion included failing to expose the Calot's triangle (1 case) because of serious edema,inflammatory adhesion and structure of bile duct couldn't be recognized,Mirizzi's syndrome(1 case),and choledochoduodenal fistula (1 case).No serous complications or fata1 cases occurred.The operative time ranged from 30 to 140min (average 80min).All the patients were followed up for 6-60 months (mean 28.5 months).All the patients recovered smoothly without any complications or fatal cases.Conclusions:It is feasible and safe to perform LC with selected patients,proper opportunity and proficient technique.