胆囊炎症期的腹腔镜胆囊切除术

胆囊炎症或行腹腔镜胆囊切除术（LC）426例，其中急诊LC59冽，经抗炎解痉治疗10～15天择期LC215例，非急诊入院，术中发现明显炎性改变15例。临床病理类型：胆囊单纯充血、水肿208例，其中转剖腹手术11例；胆囊管梗阻、胆囊肿大、积液142例，中转剖腹手术14例；胆囊坏疽和积脓76例，中转剖仅手术20例。426例LC中成功377例，中转剖腹45例问0．6％），LC术后严重并发症（需再次手术者）4例（0．9％）。作者认为胆囊炎症期行LC是安全可行的，但LC不能完全取代剖腹胆囊切除术。

LAPAROSCOPIC CHOLECYSTECTOMY FOR ACUTE AND SUBACUTE CHOLECYSTITIS

Four hundred and twenty six laparoscopic cholecystectomy (LC)were pe formed on pa-tients with acute and subacute cholecystitis,including emergency LC(59 patients), selected LC (215patients fo1lowing administration of antibiotic and antispasmotic drugs for lO- l5 days),and @selectedLC (152 patients with mild biliary co1ic without any medication). Operative findings were congestionand edema of the gallbladder(208 cases, 11 of them were achieved by laparocystectomy),impaction ofstones in the cystic infundibulum or duct with hydrops of gallbladder (142 cases, 14 of them wereachieved by laparocystectomy),and gangrene or empyema of gallbladder(76 patients, 20 of them wereachieved by laparocystectomy). LC was done successfully on 377 cases,conversion to open surgery was45 cases (10. 6 % ),severe complication occured on 4 patients for LC (reopertion, 0. 9% ). The authors be-lieve that LC for patients with acute and subacute cholecystitis is safe and suitable,but LC cannot re-place the classical laparocystectomy,