腹腔镜胆囊大部切除术456例报告

目的探讨对难处理的结石性胆囊炎患者经腹腔镜施行胆囊大部切除术的效果。方法1998年1月至2008年6月对456例难处理的结石性胆囊炎（急性胆囊炎35例，慢性结石性胆囊炎急性发伴嵌顿350例，坏疽性胆囊炎26例，萎缩性胆囊炎40例，Murizzi综合5例），采用经腹腔镜施行胆囊大部切除术。结果患者都顺利完成腹腔镜胆囊大部切除术，手术未发生胆管损伤，大出血及中转开腹，随访1月～10年无异常发现。结论对难处理的结石性胆囊炎患者施行腹腔镜胆囊大部切除术是一种具有预防医源性胆道损伤，避免术中导致大出血而中转开腹的微创手术方法。

Laparoscopic subtotal cholecystectomy for troublesome cholecystolithiasis

Objective To study theresults of laparoscpic subtotal chelecystectomy with troublesome cholecystolithiazis. Methods From January 1998 to June 2008,456 patients with troublesome cholecystolithiasis underwent laparoscopic subtotal cholecystectomy (acute cholecystitis in 35 patients ,chronic cholecyslithasis in 350, gangrenous cholecystitis in 26, atrophic cholecystitis in 40, Murizzi syndrome in 5 ). Results 456 patients had a successful laparoscopic subtotal cholecystectomy. Massive bleeding, biliary tract injury, and additional open operation were not taken place. There was no unusual postoperative complication within 1 month to 10 years. Conclusions For patients with troublesome cholecystolithiasis, laparoscopic subtotal cholecystectomy is a minimally invasive approach. It can avoid biliary tract injury, massive bleeding and additional open operation.