腹腔镜胆囊切除术治疗急性结石性胆囊炎临床体会

目的：探讨腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）治疗急性结石性胆囊炎的手术及操作要点。方法：回顾分析我院2000年3月-2009年8月行LC治疗的1260例急性胆囊炎并胆囊结石病例。结果：顺利完成LC1220例,中转开腹胆囊切除术40例,无术中大出血、肝外胆管损伤而中转开腹的病例。无术后胆汁漏、腹腔内出血等严重并发症发生。所有患者随访3月～1年,无胆管狭窄等相关并发症发生。结论：LC治疗急性胆囊炎安全可行,术者必须充分了解LC操作要点和熟练掌握操作技术。

Laparoscopic cholecystectomy for acute calculous cholecystitis

Objective： To investigate the key points of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis. Methods： The data of 1260 patients with acute calculous cholecystitis admitted to our hospital from March 2000 to August 2009 were analyzed retrospectively. Results： 1220 patients were successfully performed by LC. Meanwhile, 40 cases were converted to open cholecystectomy due to gallbladder cancer, immense ulcer of duodenum, Mirizzi＇ s syndrome, the serious adhesion between of bile duct and the ampulla part of gallbladder, or adhesion between duodenum and gallbladder, and the formation of inner fistula other than the reasons of haemorrhage and bile duct injuries outside the liver. Complications such as biliary leakage or haemorrhage in abdominal cavity were not detected after the operation. All patients make a follow-up visit during three months to one year, does not have the bile duct narrowly and so on related complication occurrence. Conclusion： Laparoscopic cholecystectomy is safe and feasible in the treatment of acute calculous cholecystitis, and successful surgery should be based on the skilled techniques and the knowledge of key points in the operation.