腹腔镜胆囊切除术治疗伴胆囊颈部结石嵌顿的急性胆囊炎的临床体会

目的 探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)对治疗伴有颈部结石嵌顿的急性胆囊炎的可行性和安全性。 方法 回顾性分析笔者医院普外科于2007年1月~2013年12月手术治疗的56例急性胆囊炎伴颈部结石嵌顿患者的临床资料,统计分析手术方式、手术效果及术后恢复情况。 结果 全部患者术中均明确诊断胆囊颈部结石嵌顿。52例顺利完成LC,4例中转开腹手术。均未发生胆管损伤、出血、胆漏或胆总管结石等并发症。52例患者术后得到随访,随访率为92.9%,随访时间6~24个月,未发生残余胆囊结石、胆管狭窄、胆总管结石等并发症。 结论 LC治疗颈部结石嵌顿的急性胆囊炎是安全、可行的,有临床应用价值。

Laparoscopic Cholecystectomy for Acute Cholecystitis with Incarcerated Gallstones

Objective To explorer the feasibility and value of Laparoscopic cholecystectomy for acute cholecystitis with incarcerated gallstones. Methods We retrospectively analyzed the clinical data of 56 cases of acute cholecystitis with incarcerated gallstones who received laparoscopic cholecystectomy (LC) from January 2007 to December 2013 in our hospital. Results Fifty-two cases underwent LC successfully and four got conversion to open surgery.All cases were recovered completely and discharged without short-term complications including bile duce injury,hemorrhage,bile leakage and common bile duct stones. Fifty two cases(92.9%) were followed up for 6-24months,and there wasn't long-term complications including bile duct stenosis,common bile duct stones and intestinal obstruction. Conclusion Delicate procedure and timely conversion to laparotomy is important during LC for acute cholecystitis with incarcerated gallstones.The condition of Calot triangle should be taken into account and a flexible application of LC skills should be selected.LC is a feasible and safe optional therapy for acute cholecystitis with incarcerated gallstones.