腹腔镜胆囊切除术在胆囊结石合并糖尿病的治疗体会

目的:探讨腹腔镜胆囊切除术在胆囊结石合并糖尿病的治疗体会。方法:对我院外一科2009年1月-2011年5月收治的80例胆囊结石合并糖尿病患者采用腹腔镜胆囊切除术,围手术期管理血糖在6.1～9.0mmol/L,记录术中出血量、术后抗生素应用时间、术后进食时间、住院时间及相应并发症。结果:术中出血量(13.54±3.69)ml,术后抗生素应用时间为(7.54±2.69)d,术后平均进食时间为(3.54±1.69)d,住院时间为(9.82±4.69)d,8例术中转开腹手术,胆道损伤1例,伤口延迟愈合9例,伤口感染12例,肺部感染3例。结论:对胆囊结石合并糖尿病患者,熟悉疾病特点、胆道系统解剖和术中转开腹手术的指征,加强围手术期血糖管理。

Treatment Experience on Laparoscopic Cholecystectomy in Gallstone Patients with Diabetes

Objective：To evaluate laparoscopic cholecystectomy in gallstone treatment of diabetes mellitus.Methods：80 cases of gallstone patients with diabetes were treated by laparoscopic cholecystectomy from January 2009 to May 2011,perioperative management of blood glucose in 6.1~9.0mmol/L.Recorded the loss of blood,the use of postoperative antibiotics time,feding time after operation,hospitalization time and the corresponding complications.Results：The volumn of intraoperatire bleeding was（13.54±3.69）ml,postoperative antibiotic time was（7.54±2.69）days,an average feeding time was（3.54±1.69）days,hospital stay was（9.82±4.69）days.8 cases convered to open surgery,1 case had bile duct injury.Wound delayed healing in 9 cases,wound infected in 12 cases,3 cases had pulmonary infection.Conclusion：The key is familiar the to feature of biliary tract anatomy and surgical indications for conversion to open surgery.Meantime it needs strengthen the management of perioperative blood glucose.