腹腔镜胆囊切除术治疗肝硬化63例

目的:探讨腹腔镜胆囊切除术(laparoscop ic cholecystectomy,LC)治疗肝硬化患者的临床疗效。方法:对2006年2月—2008年11月间在我院就诊的63例Child-Pugh A、B级肝硬化行LC治疗。结果:62例患者顺利完成LC,其中2例行胆囊大部分切除,1例因术中止血困难而中转开腹。所有患者术后无胆道损伤、术后再出血及肝功能衰竭等严重并发症。术后出现腹水3例,穿刺孔出血1例。随访2~18个月,症状消失,无复发及残留。结论:充分做好术前准备,准确掌握手术适应证及熟练的手术技巧,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。

Laparoscopic Cholecystectomy Treatment of 63 Cases of Hepatocirrhosis

Purpose： To discuss the clinical effect of laparoscopic cholecystectomy （LC） on the treatment of hepatocirrhosis. Meth- ods： 63 patients suffering from Child--Pugh Level A or B hepatocirrhosis who visited our hospital from February 2006 to Novem- ber 2008 were subject to LC treatment and analysis. Results： LC was completed in 62 cases, in which 2 cases were excised of most of the gallhIadder, and the abdominal incision of one case was interrupted due to difficult hemostasis during the operation. After the operation, all patients were free from serious complications, such as trauma of the biliary tract, postoperative hemorrhage and hepatic failure. After the operation, there were 3 cases of ascites and one case of puncture hole hemorrhage. During the follow-- up period of 2--18 months, the above symptoms disappeared without relapse or residue. Conclusion： Provided sufficient preopera- tive preparations are made, and the operative indications and skills are grasped accurately, it is safe to perform LC on hepatocir- rhosis patients, and LC is the preferred option for choleeystectomy for Level A or B hepatocirrhosis patients.