急性胆囊炎320例腹腔镜手术时机的评价与操作体会

目的　对急性胆囊炎腹腔镜手术时机进行评价 ,并总结手术操作体会。方法　将 32 0例急性胆囊炎患者分 3组施行LC。结果　早期手术组 16 4例 ,中转手术 8例 (0 .5 % ) ;限期手术组 5 1例 ,中转手术 7例 (13.7% ) ;择期手术组 10 5例 ,中转手术 5例 (0 .5 % )。平均手术时间分别为早期组4 6min、限期组 89min及择期组 35min ,平均住院时间分别为 5 .4d、13.6d及 8.7d。本组患者均痊愈出院。结论　急性胆囊炎在发病早期是行LC的理想时机 ;Calot三角的良好显露、正确处理胆囊管和胆囊动脉是LC成功的关键 ;正确对待中转手术和掌握中转手术的指征是LC的安全保证措施

Evaluation of laparoscopic operative opportunity in 320 patients with acute cholecystitis and operative understanding

Objective To evluate the choice of laparoscopic operative opportunity in 320 patients with acute cholecystitis and summarize operative understanding.Methods 320 patients with acute cholecystitis were divided into three groups and subject to laparoscopic cholecystectomy (LC).Results Eight cases ( 0.5% ) in the operative group ( n =164) at the early stage underwent open cholecystectomy (OC). Seven cases ( 13.7% ) in the operative group ( n =51) in the limited period were subjected to OC. Five cases ( 0.5% ) in the operative group ( n =105) in the selecting period received OC. The mean operative time was 46 min in the early operative group, 89 min in the limited period group and 35 min in the selecting group, respectively. The mean hospital stay was 5.4 days, 13.6 days and 8.7 days, respectively. All patients were cured.Conclusions The ideal opportunity of LC for acute cholecystitis was at the early stage. The key of LC is good exposure of Calot triangle, correct dispose of gallbladder tube and gallbladder artery. Holding indications of OC is the safe measure of LC.