腹腔镜胆囊阑尾联合切除术的临床应用  

Clinical application of combined laparoscopic cholecystectomy and appendectomy Aikebaier

作　　者：艾克拜尔·艾力[1] 克力木[1] 牛伟亚[1] 张成[1] 凯赛尔[1] 于文庆[1] 王自立[1] 居来提[1] 

机构地区：[1]新疆维吾尔自治区人民医院微创外科、疝及腹壁外科,乌鲁木齐830001

出　　处：《临床外科杂志》2010年第12期808-810,共3页Journal of Clinical Surgery

摘　　要：目的 探讨腹腔镜胆囊阑尾联合切除术的临床疗效.方法 对1993年1月至2009年12月我院施行的121例腹腔镜胆囊阑尾联合切除术的临床资料进行回顾性分析,其中腹腔镜胆囊阑尾联合手术（LC＋LA）119例,LC＋LA＋腹腔镜肝囊肿开窗术2例,其中其中慢性结石性胆囊炎96例,急性结石性胆囊炎18例,胆囊息肉7例,合并慢性或亚急性阑尾炎110例,急性阑尾炎11例,合并肝囊肿2例.结果 121例均顺利完成手术,无中转开腹,无手术并发症,平均手术时间（55.2±30.6）min,术中出血量5～50 ml,平均（10.2±8.6）ml,术后抗生素使用时间平均3.1 d,平均住院（5.0±2.2）d.106例获得门诊或电话随访,随访率87.6%,随访时间3～130个月,平均52个月,无肠瘘、残株炎、残余脓肿、粘连性肠梗阻、切口疝等手术并发症发生.结论 腹腔镜胆囊阑尾联合切除术可同时治疗胆囊和阑尾病变以及腹腔内的其他疾病,具有创伤小、恢复快、并发症少、刀口美容效果好、住院时间短、医疗费用低等优点.Objective To study the clinical application of combined laparoscopic cholecystectomy and appendectomy. Methods The clinical data of 121 patients who underwent laparoseopic cholecystectomy combined with laparoscopic appendectomy（ LC ＋ LA ） between January 1993 and December 2009 in our department were retrospectively analyzed. There were 119 cases of LC ＋ LA and 2 cases of LC ＋ LA ＋ laparoscopic treatment of liver cyst. There were chronic cholecystitis and cholecystolithiasis in 96 cases, acute cholecystitis in 18 cases, and acute appendicitis in 11 cases, chronic or subacute appendicitis in the remaining. All the patients suffered from choleeystolithiasis or gallbladder polyps, and 2 were concomitant with liver cyst. Results All the procedures were successfully completed. No conversion to open surgery and no postoperative complications occurred. The mean operative time was 55.21 ± 30.60 min, mean intraoperative blood loss was 10.2 ± 6 ml（ range ：5 -50 ml） and the mean hospital stay was 5.0 ± 2.2 d. A total of 106 patients were followed up for 3 to 130 months（ mean ：52 months） after the operation with the follow - up rate being 87.6 %. No severe postoperative complications occurred. Conclusion This procedure can treat the diseases in the gallbladder and the appendix and other abdominal visceral diseases at the same time, showing the advantages such as fewer traumas, rapid recovery, and less complications, better cosmetic result, short hospital stay, less medical treatment fee and so on. It is especially suitable for patients with multivisceral diseases, obese patients, woman of child bearing and patients with suspected appendicitis or ectopic appendix.

关 键 词：腹腔镜手术 胆囊切除术 阑尾切除术 

分 类 号：R608[医药卫生—外科学]