腹腔镜手术治疗急性化脓性胆囊炎110例

目的探讨腹腔镜手术治疗急性化脓性胆囊炎的疗效与临床价值。方法110例急性化脓性胆囊炎患者被纳入研究。常规四孔法腹腔镜胆囊切除术，对胆囊三角解剖不清者行胆囊造瘘或胆囊大部分切除术。对手术情况及临床随访结果等指标进行分析。结果97例顺利完成腹腔镜胆囊切除术，成功率88．2％（97／110）；5例行胆囊造瘘，占4．5％，8例胆囊大部切除，占7．3％。手术时间45～175min，平均70min。无胆管损伤、胆漏、出血等严重并发症发生。术后随访3～6个月，无黄疸、腹痛、发热等并发症，无胆总管残留结石。结论腹腔镜胆囊切除术治疗急性化脓性胆囊炎具有创伤小、痛苦轻、恢复快、瘢痕小、疗效佳等优点，值得临床推广应用。

Laparoscopic surgery in treatment of acute suppurative cholecystitis

ObjectiveTo explore the clinical efficacy and value of laparoscopic surgery in treatment of acute suppurative cholecystitis.Methods110 patients of acute suppurative cholecystitis were included in the study.They were underwent laparoscopic cholecystectomy by the conventional four-hole method.If the anatomy of Calot’s Triangle unclear,the patient was most gallbladder fistula or gallbladder surgery.Clinical parameters were analyzed including surgical cases,and clinical follow-up results.Results97 cases were the successful with completion of laparoscopic cholecystectomy(88.2%),5 cases with routine gallbladder fistula(4.5%) and 9 cases with routine subtotal cholecystectomy.Operative time was an average of 70 min(45-175 min).There were no bile duct injury,bile leakage,bleeding and other serious complications.ConclusionLaparoscopic surgery is worthy of clinical application in treatment of acute suppurative cholecystitis with less trauma,less pain,faster recovery,smaller scars,good effect,etc.