腹腔镜手术治疗合并肝硬化胆囊结石的临床分析  

Clinical Analysis on Laparoscopic Cholecystectomy in Cirrhotic Patients

作　　者：辛建[1] 陶凯雄[2] 夏泽锋[2] 刘兴华[2] 陈少飞[2] 赵建国[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院西区普外科,武汉430056 [2]华中科技大学同济医学院附属协和医院普外科,武汉430022

出　　处：《华中科技大学学报（医学版）》2010年第4期532-535,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨腹腔镜胆囊切除术治疗合并肝硬化的胆囊结石患者的可行性与疗效。方法回顾性分析2004年-2009年收治的211例合并肝硬化的胆囊结石患者的临床资料。所有患者随机分成腹腔镜组（118例）和开腹组（93例）,比较两组间手术中及手术后各项指标,并进行统计学分析。结果腹腔镜组的手术时间、术中出血量和平均住院日均低于开腹组,平均住院总费用高于开腹组,差异具有统计学意义（P〈0.05）;腹腔镜组手术前后总胆红素、白蛋白、AST、ALT和GGT的变化明显小于开腹组,差异有统计学意义（P〈0.05）,而直接胆红素、间接胆红素和ALP的变化差异无统计学意义;手术并发症发生率上两组无明显差异（P〉0.05）。结论对合并肝硬化（肝功能Child A,B级）的胆囊结石患者实施腹腔镜胆囊切除术是安全可行的,腹腔镜胆囊切除术对合并肝硬化的胆囊结石的治疗具有明确的优势。Objective To investigate the feasibility and benefits of laparoscopic cholecystectomy（LC）in cirrhotic patients with cholecystolithiasis. Methods The clinical data of 211 cases of cholecystolithiasis associated with liver cirrhosis were retro spectively analyzed. All patients were divided into laparoscopic cholecystectomy group and open cholecystectomy group. The op- erative time,blood loss, length of hospital stay, hospital costs, blood biomedical examination and surgical complications were compared between the two groups. Results As compared with open cholecystectomy group, the operative time and hospital stay were shorter, blood loss was less, the hospital costs were more, and the changes of total bilirubin, albumin, AST, ALT and GGT were milder in laparoscopic cholecystectomy group. The differences were statistically significant（P〈0. 05）. But the difference in post operation complications between two groups was not significant（P〉0.05）. Conclusion Laparoscopic cholecystectomy has a minimally invasive advantage on liver cirrhosis patients（Child A or B）with cholecystolithiasis.

关 键 词：胆囊结石 肝硬化 腹腔镜胆囊切除术 

分 类 号：R657.42[医药卫生—外科学]