腹腔镜胆囊切除术治疗急性胆囊炎临床分析

目的探讨腹腔镜胆囊切除术(LC)治疗急性胆囊炎的手术时机及效果。方法对实施腹腔镜胆囊切除术466例分急诊手术、限期手术组与择期手术组,对比分析三组手术时间、术后住院时间、中转开腹率及并发症发生率。结果急诊手术组80例,中转开腹5例(6.25%);限期手术组111例,中转开腹13例(11.7%);择期手术组275例,中转开腹8例(2.9%)。术后平均住院时间分别为7.1天、9.1天、6.5天。平均手术时间分别为55分钟、95分钟、50分钟。并发症率分别为1.25%、0.90%、0.36%。三组患者均痊愈出院。结论急性胆囊炎在发病早期是行LC的最好时期,择期手术仍切实可行;正确处理胆囊管及胆囊动脉是LC手术的关键;正确对待中转开腹是手术安全的保障。

Clinical Analysis of Laparoscopic Cholecystectomy for Acute Cholecystitis

Objective To discuss the operation juncture and effect of laparoscopic cholecystectomy(LC) for acute cholecystitis.Methods 466 cases receiving LC were divided into 3 groups: the acute operation group,the limited operation group and the selective operation group,comparative analysis among the 3 groups was made to the operation time length,post-operation hospitalization period,the rate of the conversion to open cholecystectomy(OC) and the occurrence of complications.Results 5 cases out of 80 cases(6025%) in the acute operation group received OC,as well as 13 cases out of 111 cases(11.7%) in the limited operation group and 8 cases out of 275 cases(2.9%) in the selective operation group; the average post-operation hospitalization were 7.1 days,9.1 days and 6.5 days respectively;the average operation duration were 55 minutes,95 minutes and 50 minutes respectively;the occurrence of complications were 1.25%,0.90% and 0.36% respectively;all the patients in the 3 groups recovered.Conclusion The early stage of the occurrence of acute cholecystitis is the best time for LC,correct deal with cystic duct and artery is the key-point of LC.