微波治疗在合并肝硬化胆囊切除术胆囊床出血中的应用

目的:探讨微波治疗在胆囊结石合并肝硬化患者腹腔镜胆囊切除术中对胆囊床出血的止血效果。 方法:腹腔镜治疗症状性胆囊结石合并肝硬化患者手术中13例患者胆囊床出现难以制止的出血，采用南京康有KY-2000微波消融治疗仪，在腹腔镜指导下凝固止血，微波功率60 W，连续凝固，直至出血停止。 结果:13例患者中6例行单点凝固，7例行多点凝固，每个凝固点经2~5 min连续凝固，出血停止。手术后未发生再出血。患者手术后肝功较手术前未出现明显改变，手术后未出现黄疸。3~5 d拔除引流管，未出现腹腔积液等并发症。 结论:合并肝硬化的腹腔镜胆囊切除术，出现胆囊床难以制止的出血时微波凝固治疗是一个较好的止血措施。

Application of microwave therapy in cholecystectomy for cholecystolithiasis complicated with cirrhosis

Objective To investigate the hemostatic effect of microwave therapy in laparoscopic cholecystectomy for patients with cholecystolithiasis complicated with cirrhosis. Methods Uncontrollable bleeding occurred in the gallbladder bed of 13 patients receiving laparoscopic treatment for symptomatic cholecystolithiasis complicated with cirrhosis. KY-2000 microwave ablation instrument with microwave power of 60 W was used for coagulation and hemostasis in patients. Coagulation continued until the bleeding stopped. Results Of 13 patients, 6 received single point coagulation, 7 received multiple-point coagulation. Coagulation at each point lasted for 2-5 min, and the bleeding stopped. No more bleeding after the operation. No significant changes were found in liver function after operation, and no jaundice was developed. The drainage tube was removed in 3-5 d, and no complications such as abdominal effusion were observed. Conclusion The proposed microwave therapy is a good method to stop the uncontrollable bleeding occurring in the gallbladder bed during laparoscopic cholecystectomy for cholecystolithiasis complicated with cirrhosis.