腹腔镜治疗急性结石性胆囊炎的临床观察  

Clinical Observation of Effect of Laparoscopic Cholecystectomy in Treatment Acute Calculouths Cholecystitis Patients

作　　者：车河龙[1] 叶祥燕[1] 陈保华[1] 林洪武[1] 姚斌[1] 邱卫明[1] 

机构地区：[1]解放军第184医院普通外科,江西鹰潭335000

出　　处：《河北医学》2009年第5期521-524,共4页Hebei Medicine

摘　　要：目的:探讨腹腔镜治疗急性胆囊炎的手术指征、手术时机、手术方法。方法:对我院1997年5月至2008年5月368例急性结石性胆囊炎施行腹腔镜胆囊切除术进行回顾性分析。结果:368例中345例成功完成经腹腔镜胆囊切除术,术后恢复良好,无术后严重并发症和死亡。23例中转开腹,其中11例是因为胆囊三角解剖不清,5例因为无法控制出血,2例合并胆囊十二指肠瘘,1例术中发现电凝钩损伤肠管,4例为手术器械故障。结论:经腹腔镜治疗急性结石性胆囊炎安全可行,正确把握手术适应证、掌握好手术技巧是手术成功的关键。Objective： To explore the indication, operation time, methods and skills of laparoscopic cholecstectomy in acute calculous cholecystitis patients. Methoid： Clincal data and therapy results of 368 consecutive cases of patients with acute calculous cholecystitis who had undergone laparoscopic cholecystectomy during the time from May 1997 to May 2008were retrospectively analyzed. Result： 345 cases were successfully treated by laparoseopic cholecstectomy while 23 cases were converted to open abdominal procedure , among which 11 case with obscure anatomy on gallbladder triangle area, 2 cases with uncontralabe bleeding, one case with injury of intestinal wall caused by electric coagulation hook, and rest 4 cases were quit because of malfunction of surgical instruments. Conclusion ： Laparoscopic cholecystectomy can be safely used in acute calculouths cholecystitis patients with high success rate and low risk of procedure - related complications,and selection the proper patients and correct manipulation during operation may be of great importance for the success.

关 键 词：腹腔镜 急性结石性胆囊炎 胆囊切除术 

分 类 号：R657.41[医药卫生—外科学]