25例坏疽性胆囊炎的临床分析及腹腔镜手术探讨  

Clinical analysis for laparoscopic cholecystectomy in gangrenous cholecystitis

作　　者：周粼[1] 梁道明[1] 陈嘉勇[1] 甘平[1] 孙敏[1] 

机构地区：[1]昆明医学院附属第二医院普通外科,昆明650101

出　　处：《重庆医学》2009年第3期299-300,共2页Chongqing medicine

摘　　要：目的探讨急诊腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗坏疽性胆囊炎。方法对2005年9月至2007年9月昆明医学院附属第二医院普外科急性坏疽性胆囊炎25例患者的多种临床指标进行分析。结果17例成功行LC,其成功率68%,8例(32%)中转开腹。发生胆囊坏疽的危险因素有年龄、合并症、白细胞计数。老年(50岁以上)合并有糖尿病,急性发病时间较长,白细胞计数在17×109/L以上的急性胆囊炎患者胆囊坏疽的危险性增加。结论急诊行LC并放宽手术指征是处理坏疽性胆囊炎的有效治疗方案。Objective To investigate laparoscopic cholecystectomy in urgent treating acute gangrenous cholecystitis. Methods To analyze the clinical variables from 25 patients with acute gangrenous cholecystitis and with laparoscopic cholecystectomy for sta tistics in the Department of General Surgery, the Second Affiliated Hospital of Kunming Medical College from 2005 to 2007. Results Seventeen patients were successfully undergone laparoscopic cholecysteetomy and the successful rate was 68 %, but 8 patients had open conversion（32 % ）. The risk factors for gallbladder gangrene included age, complicating diabetes, time of acute onset and white blood counting. It was suggested that the risk for gallbladder gangrene in the aged patients（more than 50 years）with acute chlolecystitis associated with diabetes,long time of acute onset and white blood cell counting greater than 17 × 10^9/L was increased. Conclusion Urgent laparoscopic cholecystectomy with low threshold for conversion to open cholecysteetomy is an effective treatment for gangrenous cholecystitis.

关 键 词：坏疽性胆囊炎 腹腔镜胆囊切除术 临床分析 

分 类 号：R657.41[医药卫生—外科学]