胆囊急性炎症期的腹腔镜治疗69例

目的探讨胆囊急性炎症期腹腔镜胆囊切除术(LC)的手术方法。方法对69例胆囊急性炎症期患者施行LC。对手术时间、副损伤、术后胃肠功能恢复和感染率及出院时间进行分析。结果本组病例中64例患者顺利完成手术，成功率92.7％。因术中发现胆囊三角处瘢痕性粘连，无法分离而中转开腹2例；术中因损伤胆总管或胆囊动脉出血而中转开腹3例。平均手术时间为45min(30—160min)，除2例患者因胆总管损伤，中转开腹行胆总管重建，支架管引流带管出院(半年后拔管外)，其余患者均在1周内临床治愈出院。结论掌握了LC的操作技巧及娴熟的解剖位置，对胆囊急性炎症期患者大多可行LC并获得更满意效果。

CLINICAL ANALYSIS OF LAPAROSCOPIC CHOLECYSTECTOMY ON ACUTE CHOLECYSTITIS:A REPORT OF 69 CASES

Objective To assess the feasibility and safety of performing laparoscopic cholecystectomy (LC) on acute cholecystitis. Methods We had performed LC on 69 patients suffering from acute cholecystitis. The operation time, complications and infection morbidity were observed and analyzed. Results 64 cases were successfully completed by LC without complications. 2 cases were conversed to open cholecystectomy(OC) because of difficulty in dissection around Calot's triangle and obscure anatomy. 3 cases were conversed to OC because of the complications of common bile duct injuries and bile artery bleeding. The mean operating time was 45 minutes (range from 30 to 160 minutes). They all resumed rapidly and the mean convalescent time was 24 hours (range from 12 to 36 hours). No infection was found and the mean hospital stay was 5.3 days (range from 5 to 6 days). Conclusion We believe that with the proficient skill of operation and precise anatomical position, acute cholecystitis could be successfully treated with LC.