胆囊切除术在肝硬化大量腹水合并症状性胆囊结石治疗中的作用

目的探讨胆囊切除术在治疗肝硬化大量腹水合并症状性胆囊结石的作用及其安全性。方法回顾性分析我院2006年7月～2009年6月胆囊切除术治疗12例肝硬化大量腹水合并症状性胆囊结石患者的临床资料,并随机抽取同期肝硬化大量腹水无症状性胆囊结石12例非手术患者进行对照研究。结果与对照组比较发现:手术组平均住院日缩短11.2d(p<0.01)、腹水完全消退时间缩短7.2d(p<0.01)、肝功能改善明显(p<0.05),术后3个月腹水复发率下降。无手术死亡病例,术后出现1例中量腹水病人,3例少量腹水。结论肝硬化大量腹水合并胆囊结石患者行胆囊切除术有利于改善肝功能和腹水的控制,在一定程度上可以减缓肝硬化病情的发展。术前积极改善肝功能,严格掌握手术适应证,为此类患者行胆囊切除术安全可行。

THE EFFECT OF CHOLECYSTECTOMY ON THE SYMPTOMATIC CHOLECYSTOLITHIASIS PATIENTS WITH CIRRHOSIS AND MASSIVE ASCITES

Objective To investigate the effect and its reliability of cholecystectomy on the symptomatic cholecystolithiasis patients with cirrhosis and massive ascites.Methods Retrospective analysis of 12 cases of the symptomatic cholecystolithiasis patients with cirrhosis and massive ascites,from July 2006 to June 2009. And randomly selected 12 asymptomatic cholecystolithiasis patients with cirrhosis and massive ascites were enrolled to control study over the same period.Results Compared with the control group：The operation group＇ s average length of stay shortened 11.2 d （p 〈 0. 01 ） , ascites disappeared completely shortened 7.2 days（p 〈0. 01 ）, liver function improved significantly （ P 〈 0. 05 ） , ascites recurrence rate has dropped. There was no operative deaths, 1 case occurred moderate ascites postoperative, 3 cases occurred a little ascites postoperative. Conclusion Strictly controlling surgical indication, cholecystectomy will be beneficial to the control of ascites on the symptomatic choleeystolithiasis patients with cirrhosis and massive ascites, to a certain extent can retard the disease progresses, and achieve more satisfactory therapeutic effect. For these kind patients, cholecystectomy is safe and feasible.