肝硬化患者腹腔镜胆囊切除术36例临床分析

目的 探讨腹腔镜胆囊切除术（LC）在治疗肝硬化患者中的临床效果.方法 对2005年1月～2010年8月间在笔者所在医院就诊的36例Child-Pugh A、B级肝硬化行LC的患者进行分析.结果 36例患者顺利完成LC,其中3例行胆囊大部分切除,3例因术中止血困难而中转开腹.所有患者术后无胆道损伤、术后再出血及肝功能衰竭等严重并发症.术后出现腹水3例,穿刺孔出血2例.结论 充分做好术前准备,准确掌握手术适应证,熟练的手术技巧,肝硬化患者行LC是安全的,对于肝功能A、B级须切除胆囊者应首选LC.

Clinical analysis of laparoscopic cholecystectomy using in the patients associated with cirrhosis on 36 cases

Objective To discuss the clinical effect of laparoscopic cholecystectomy （LC） on the treatment of hepatocirrhosis. Methods 36 patients suffering from Child - Pugh Level A or B hepatocirrhosis who visited our hospital from January 2005 to August 2010 were subject to LC treatment and analysis. Results LC was completed in 33 cases, in which 3 cases were excised of most of the gallbladder, and the abdominal incision of three case was interrupted due to difficult hemostasis during the operation. After the operation, all patients were free from serious complications, such as tramna of the biliary tract, postoperative hemorrhage and hepatic failure. After the operation, there were 3 cases of ascites and 3 case of puncture hole hemorrhage. Conclusion Provided sufficient preoperative preparations are made, and the operative indications and skills are grasped accurately,it is safe to perform LC on hepatocirrhosis patients, and LC is the preferred option for cholecystectomy for Level A or B hepatocirrhosis patients.