腹腔镜保胆取石术61例报告

目的:探讨腹腔镜保胆取石术的手术指征、技巧及临床应用价值。方法:回顾分析2010年7月至2011年8月为61例患者行腹腔镜保胆取石术的临床资料。结果:61例手术均获成功,手术时间30～95 min,平均(52.3±14.8)min;术后第2天下地活动并进流质饮食,术后肠蠕动恢复时间10.2～21.6 h,平均(16.4±2.4)h;术后住院3～7 d,平均(4.2±1.1)d。术后1例出血,再次行开腹胆囊切除术。未发生胆漏、肠漏、切口感染、胆管损伤等其他并发症。术后随访3～12个月,无复发,胆囊收缩功能良好。结论:腹腔镜保胆取石术对于保留胆囊及胆囊功能具有重要意义,安全、可行、微创,最大限度地提高了患者的生存质量,但应严格把握手术指征。

The clinical analysis of laparoscopic gallbladder-preserving cholelithotomy:a report of 61 cases

Objective:To investigate the indications,skills and clinical value of laparoscopic gallbladder-preserving cholelithotomy.Methods:Retrospective analysis was made on the clinical data of 61 cases of laparoscopic gallbladder-preserving cholelithotomy from Jul.2010 to Aug.2011.Results:All operations were successfully performed.One case had the bleeding which healed up with second open operation.Patients were followed up for 3-12 months,the mean operative time was(52.3±14.8) min(range 30-95 min).Ambulation and liquid diet were achieved on the second postoperative day.The average recovery time of peristalsis was(16.4±2.4) h(range 10.2-21.6 h).The mean postoperative hospital stay was(4.2±1.1) d(range 3-7 d).1 case of haemorrhage was found after operation,and this patient underwent open cholecystectomy.No other complications occurred such as bile leakage,intestinal leakage,incision infection or bile duct injury.Patients were followed up for 3-12 months,and no recurrence of stones was found.The contractive function of gallbladder was favorable.Conclusions:Laparoscopic gallbladder-preserving cholelithotomy plays an important role in the preservation of gallbladder and the contractive function of gallbladder.It is safe,feasible and minimally invasive for cholecystolithiasis.The life quality of patients is maximally increased,but the surgical indications should be strictly grasped.