腹腔镜下胆囊切除术联合中西药物治疗胆囊结石合并胆囊炎

目的：探讨腹腔镜下胆囊切除术联合中西药物治疗胆囊结石合并胆囊炎的临床疗效和安全性。方法：2008年2月～2011年11月，采用腹腔镜下胆囊切除术联合中西药物治疗胆囊结石合并胆囊炎患者58例。男26例，女32例；年龄53-69岁，中位数61岁；病程1周～6年，中位数1-3年。手术采用腹腔镜下胆囊切除术，腹腔镜下分离胆囊三角，夹闭胆囊管和胆囊动脉，从肝脏上剥离切除胆囊。手术前后采用大柴胡汤加减，每日1剂，每剂煎2次，分早晚2次空腹服用；同时给予头孢唑林钠静脉点滴及补液治疗。结果：腹腔镜下切除胆囊顺利，5例因胆囊周围炎症较重，切除胆囊后行腹腔引流，其余患者均未留置腹腔引流管。本组患者均获随访，随访时间6～24个月，无出血、胆漏、结石残留、胆管损伤、十二指肠损伤、腹膜炎、切口感染等并发症发生。结论：采用腹腔镜下胆囊切除术联合中西药物治疗胆囊结石合并胆囊炎，创伤小，方法简便，临床疗效好，安全性高，值得临床推广应用。

Treating gallbladder stones merge cholecystitis by LC plus integrative medicine

Objective:To investigate the clinical efficacy and safety of treating gallbladder stones merge cholecystitis by LC plus the integrative medicine.Methods:From February 2008 to November 2011 treating 58 cases of gallbladder stones merge cholecystitis by LC plus the integrative medicine.26 males and 32 females;age from 53 to 69 years,median 61 years;duration from1 week to 6 years,with a median of 1.3 years.Surgery using a LC.Using the Da chaihu decoction before and after surgery,one recipe a day,each dose of fried two times sooner or later,two empty stomach morning and evening;at the same time,given them cefazolin sodium intravenous rehydration therapy treatment.Results:LC smoothly,and five cases due to severe inflammation of the gallbladder around cholecystectomy underwent peritoneal drainage of the remaining patients indwelling peritoneal drainage tube.This group of patients were followed up for 6 to 24 months,no bleeding,bile leakage,residual stones,bile duct injury,duodenal injury,peritonitis,wound infection and other complications.Conclusion:The method of treating gallbladder stones merge cholecystitis by LC plus the integrative medicine is simple and safety,and is worthy of clinical application.