腹腔镜治疗残余胆囊的体会

目的探讨腹腔镜治疗残余胆囊的可行性、安全性。方法对2000年1月～2009年9月我院收治的35例经腹腔镜手术治疗残余胆囊患者的临床资料进行回顾性分析。首次均因胆囊结石行胆囊切除手术,其中开腹胆囊切除术后20例,小切口胆囊切除术后8例,腹腔镜胆囊切除(LC)术后7例。首次行急诊胆囊切除术23例。术中分离粘连,暴露游离胆总管前壁后,沿胆总管逆向寻找残余胆囊,确认后切除。结果 35例手术均获成功,平均手术时间75min(40～130min);术中出血10～120ml。住院时间5～10d,平均7.6d,无中转开腹。术后随访1～6个月,无胆道相关并发症。结论腹腔镜手术治疗残余胆囊是一种安全、可行的治疗方法 。

Experience on Laparoscopy in the Treatment of Residual Gallbladder

Objective To evaluate the feasibility and safety of laparoscopic surgery used in the treatment of residual gallbladder. Methods From January 2000 to September 2009,we performed laparoscopy on 35 cases of residual gallbladder. Before the operation,all of the patients had received cholecystectomy,via open （20 cases）,small-incision （8 cases）,or laparoscopic approaches （7 cases）,because of gallbladder stones. Among them,twenty patients received the first cholecystectomy in emergency. In the second surgery that we carried out,we separated the adhesive tissues to expose the anterior wall of the common bile duct,along which the residual gallbladder was explored,and then resected. Results The laparoscopic surgery were completed successfully in all of the cases with a mean operation time of 75 minutes （ranged from 40 to 130 minutes）. During the operation,the patients had 10-120 ml blood loss. No patient was converted to open surgery. They were discharged from hospital in 5 to 10 days （mean,7.6 days）. Afterwards,a 1-to 6-month follow-up was carried out,during which no bile duct related complications were observed. ConclusionsLaparoscopic surgery is feasible and safe for patients with residual gallbladder.