急性胆囊炎腹腔镜胆囊切除术420例报告

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗急性胆囊炎的可行性及安全性。方法:回顾分析2000年2月至2011年8月为420例急性胆囊炎患者行LC的临床资料。结果:402例顺利完成LC。18例中转开腹行胆囊切除术,其中Mirizzi综合征5例,胆囊三角"冰冻样"粘连12例,1例胆总管损伤行胆管修补及T管引流术,术后6个月拔除T管。5例术后发生胆漏,均保守治疗痊愈。术后随访6～12个月,无胆管狭窄、胆管残余结石、残余小胆囊等严重并发症发生。结论:只要术者熟练掌握操作技巧,提高术中应变能力,为急性胆囊炎患者行LC是安全可行的。

The clinical analysis of laparoscopic cholecystectomy for acute cholecystitis

Objective:To discuss the feasibility and safety of laparoscopic cholecystectomy(LC) in treatment of acute cholecystitis.Methods:The clinical data of 420 patients with acute cholecystitis who underwent LC from Feb.2000 to Aug.2011 was retrospectively analyzed.Results:The 402 cases of LC were performed successfully,in which 18 cases were changed to open cholecystectomy(5 cases of Mirizzi syndrome,12 cases of gallbladder triangle "ice-like" adhesion,1 case of bile duct injury underwent biliary T-tube repair and drainage,T tube was removed after 6 months).5 cases of postoperative bile leakage were treated conservatively and cured.All patients were followed up for 6 months to 12 months,there was no bile duct stricture,residual bile duct calculi,remnants of a small gallbladder or other serious complications.Conclusions:LC treatment of acute cholecystitis is safe and feasible as long as doctors are able to master the surgical technique and they are flexible to face sudden event.