肝硬化患者行腹腔镜胆囊切除术的临床分析

目的:探讨肝硬化患者腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的可行性、安全性及手术技术特点。方法:回顾分析120例Child A、B级肝硬化患者行LC的临床资料。结果:中转开腹8例。中转原因:结石嵌顿、Calot三角粘连5例;术中出血,镜下止血困难2例;术中发现胆道变异1例。LC平均手术时间(40.3±12.5)min,术中平均出血(60.8±19.5)ml,术中无损伤,术后出血、肺部感染、泌尿系感染各1例。无肝功能衰竭等严重并发症,均治愈出院,术后平均住院(5.2±2.0)d。结论:对于Child A、B级肝硬化患者,LC是一种安全可行的微创手术。

Laparoscopic cholecystectomy for patients with liver cirrhosis

Objective:To evaluate the feasibility,safety and technical characteristics of laparoscopic cholecystectomy(LC) in patients with hepatic cirrhosis.Methods:LC were performed in 120 patients with liver cirrhosis of Child A and B,and clinical data were analyzed retrospectively.Results:LC was successfully performed in 112 patients.8 cases were converted to open cholecystectomy(OC),among whom 5 cases were because of stone incarceration and dense adhesion of Calot triangle,2 cases of difficult management of bleeding under laparoscopy and 1 cases of anatomic variation of external hepatic biliary duct.The average operation time of LC was(40.3±12.5)min and the average blood loss was(60.8±19.5)ml.There was no injury during the operation.Postoperative complications included bleeding in 1 case,respiratory tract infection in 1 case,and urinary tract infection in 1 case.All patients recovered smoothly and discharged from hospital(5.2±2.0)days after LC.Conclusions:Laparoscopic cholecystectomy is a feasible and safe minimal invasive operation in patients with liver cirrhosis of Child A and B.