腹腔镜胆囊切除术在肝硬化患者中的应用(附57例报告)

目的:探讨合并肝硬化患者腹腔镜胆囊切除术(LC)的可行性与技术特点。方法:回顾分析57例合并肝硬化患者LC的临床资料。结果:成功56例,1例因术中出血,镜下止血困难中转开腹。术中无损伤。术后胆囊窝积液1例,经保守治疗8d后完全吸收。腹水增多1例,无腹腔及消化道出血、肝功能衰竭等严重并发症,患者均治愈出院。结论:肝硬化患者行LC是相对安全的,掌握手术的技术特点、注重围手术期的处理及Ch ild-push分级是成功的关键。

Application of laparoscopic cholecystectomy in cirrhotic patients:with a report of 57 cases

Objective:To evaluate the feasibility and technical characteristics of laparoscopic cheolecystectomy(LC) in cirrhotic patients.Methods:The clinical data of 57 cirrhotic patients received LC was retrospectively analyzed.Results:LC was successfully performed in 56 patients except that 1 case was converted to laparotomy for bleeding.No injury occured during the operation.One case who complicated with hydrops in the gallbladder bed was cured through conservative treatment 8 days later.Ascites increased in one case,but no bleeding of abdominal cavity and upper digestive tract,and failure of liver function were found in all cases.Conclusions:LC for cirrhotic patients is relatively safe.It is important to know the technical characteristics and to pay attention to the perioperative management and Child-push classification.