Laparoscopic cholecystectomy.

The technique of laparoscopic cholecystectomy is probably the most significant major surgical advance of the last decade. It allows shorter hospitalization, rapid recovery and early return to work. Significant financial savings may be achieved over current conventional treatment. In this article the procedure is reviewed and its advantages and drawbacks are discussed.     

腹腔镜胆囊切除治疗急性胆囊炎280例

目的 总结腹腔镜胆囊切除术(LC)治疗急性胆囊炎的经验.方法 对280例急性胆囊炎患者行LC治疗.结果 268例成功完成LC;12例中转开腹,其中5例Calot三角粘连致密,2例出血不能控制,3例Mirizzi综合征,2例胆总管损伤分别行胆总管空肠Y型吻合术和T形管引流术.术后未发生腹腔出血、胆漏及膈下脓肿等并发症,术后平均住院时间4.7 d.结论 LC治疗急性胆囊炎是一种切实可行的方法.关键是术者选择好手术时机、把握好中转开腹指征并掌握熟练的腹腔镜操作技术.     

Laparoscopic cholecystectomy. Initial experiences]

Between February 1991 and July 1991, 74 laparoscopic cholecystectomies were performed. The number of all cholecystectomies during this period was 168. Two surgeons performed the operations. Stone in the common bile duct, old age, acute cholecystitis, severe obesity and heart rhythm disorders were regarded as contraindications. The duration of the operation was 45-210 min. (mean 127 min). The intervention was diverted to open cholecystectomy in 2 instances (2.7%). Early postoperative complications were observed in 2 cases (2.7%): biliary discharge and bleeding. Reoperation was necessary in one patient (1.3%) because of bleeding. There was no operative mortality. The mean duration of hospitalization was 5.6 days, and the mean postoperative period was 2.7 days. It is considered that, laporoscopic cholecystectomy can be carried out only by specialists in both bile surgery and laparoscopic techniques, provided that all the personal and technical conditions necessary for traditional cholecystectomies are at hand. Both medically and economically, the laparoscopic cholecystectomy results attain or even exceed those of the traditional open technique.     

Laparoscopic cholecystectomy in teenagers

The positive experience with laparoscopic cholecystectomy (LC) in the adult surgical community encouraged us to perform LC in our last nine adolescent patients requiring cholecystectomy. There were no operative or postoperative complications, and the average hospital stay was less than 3 days. All the teenagers resumed their normal activities 1 week after surgery and were pleased with the small operative scars. Once the technique has been mastered and adequate experience gained with the new instrumentation, laparoscopic cholecystectomy would seem to offer many advantages in the teenage patient.     

腹腔镜胆囊切除术在急性胆囊炎中的应用

目的对急性胆囊炎患者在腹腔镜下对患者进行胆囊切除手术,对其的治疗效果进行分析和总结。方法该院在2011年1月—2013年2月期间,对收治的498例急性胆囊炎患者的临床资料进行回顾性分析和总结。对这些患者进行随机分组,分成试验组和对照组,分别为249例。对照组:从患者的胆囊三角后侧进行解剖;试验组:对患者进行腹腔镜胆囊三角Ⅴ型解剖;对两组患者在手术后出现的并发症进行分析。结果在试验组中:患者在手术中,胆道的损伤患者有3例,占1.2%;胆漏患者有2例,占0.8%。在对照组组:胆道损伤患者有20例,占8%;胆漏患者有12例,占4.8%。对两组患者的并发症进行比较和分析,差异显著,具有统计学意义(P<0.05)。结论对患者进行胆囊切除,采用腹腔镜胆囊三角V型解剖,效果显著,减少在手术中出现的并发症。