冲吸钝性解剖法在急性胆囊炎腹腔镜胆囊切除术中的应用

目的探讨冲吸钝性解剖法在急性胆囊炎腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中的应用价值。方法 2002年9月～2009年4月,110例急性胆囊炎行LC,切断胆囊管前常规行冲吸钝性解剖法暴露肝总管。结果 108例LC成功,2例因为严重的腹腔粘连而中转开腹。手术时间28～120 min,平均52 min。术后住院3～7 d,平均4 d。无胆道损伤、胆漏、术中出血等并发症。93例随访1～72个月,平均25个月,无腹痛、发热、黄疸等症状发生。结论在急性胆囊炎LC术中应用冲吸钝性解剖法能有效防止术中胆道损伤,安全可靠,值得临床推广。

Blunt Dissection by Swashing and Suction in Laparoscopic Cholecystectomy for Acute Cholecystitis

Objective To discuss the value of swashing and suction blunt dissection technique in laparoscopic cholecystectomy（LC） for acute cholecystitis. Methods From September 2002 to April 2009,we performed LC on 110 cases of acute cholecystitis by using swashing and suction for blunt dissection to expose the common hepatic duct before transecting the cystic duct. Results LC was completed in 108 of the patients,the other 2 cases were converted to open surgery because of severe abdominal adhesion.The mean LC time was 52 min（28-120 min）.After the operation,the patients were discharged from the hospital in 3 to 7 days（mean,4 days）.No bile duct injury,biliary leakage,or postoperative hemorrhage occurred in this series.Of the patients,93 cases were followed up for 1 to 72 months（mean,25 months）,during which no abdominal pain,fever or jaundice were observed. Conclusions Blunt dissection by swashing and suction is an effective technique for preventing biliary injury during LC.The method is safe and can be used widely.