腹腔镜下萎缩性胆囊炎切除方法的探讨

目的：总结腹腔镜下慢性结石性萎缩性胆囊炎胆囊切除的手术方法和经验。方法：总结2003年1月～2007年5月36例慢性结石性萎缩性胆囊炎患者行腹腔镜胆囊切除术中分离胆囊周围粘连、解剖Calot三角、处理胆囊管及胆囊动脉、切除胆囊的方法。结果：腹腔镜下胆囊切除30例,中转开腹6例。4例胆囊三角区广泛致密粘连,无法分离,行开腹胆囊大部切除术。腹腔镜术后胆漏2例,经腹腔引流治愈。结论：萎缩性胆囊炎腹腔镜手术治疗是安全的。仔细分离胆囊周围粘连,辨认壶腹部与胆囊管的交界,准确解剖Calot三角,合理处理胆囊管,正确掌握中转开腹时机是成功完成手术的关键。

The exploration of laparoscopic cholecystectomy on patients with chronic atrophic cholecystitis

Objective:To summarize the experience of laparoscopic cholecystectomy on patients with chronic atrophic cholecystitis.Methods:The clinical data of 36 cases of laparoscopic cholecystectomy on patients with chronic atrophic cholecystitis was analyzed retrospectively.Results:Thirty cases were performed successfully with 4 cases of subtotal laparoscopic cholecystectomy for severe adhesion of Calot's triangle.6 cases were converted to open procedures.Conclusions:Laparoscopic cholecystectomy on patients with chronic atrophic cholecystitis is safe.To dissect the adhesion seriously,to deal with the Calot's triangle correctly and to convert to open procedure appropriately is the key of successful laparoscopic procedure.