急性炎症期胆囊结石的无异物腹腔镜胆囊切除术  

Clipless Laparoscopic Cholecystectomy for Patients with Calculous Cholecystitis in Acute Inflammation Stage

作　　者：所广军[1] 徐安安[1] 胡海[1] 

机构地区：[1]同济大学附属东方医院微创外科,上海200120

出　　处：《中国普外基础与临床杂志》2011年第2期168-171,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：浦东新区科技发展基金项目(项目编号:PKJ2009-Y21)~~

摘　　要：目的探讨无异物腹腔镜胆囊切除术（LC）治疗急性期结石性胆囊炎的可行性。方法回顾性分析2008年12月至2010年7月期间在我院接受三孔法LC的169例急性期结石性胆囊炎患者的临床资料。结果除1例因胆囊穿孔中转开腹外,其余病例均经三孔法完成LC操作。手术时间25~70 min,平均38 min;术中出血量10~200 ml,平均22 ml。38例患者放置腹腔引流管,术后1~6 d（平均1.8 d）拔除。术后2 h下床活动,术后住院3~7 d,平均3.5 d,无胆管损伤、出血、漏胆、腹腔感染等并发症发生。结论在手术经验积累及娴熟的手术技巧基础上,开展急性期结石性胆囊炎的无异物LC是安全、可行的。Objective To evaluate the feasibility of clipless laparoscopic cholecystectomy（LC） to patients with calculous cholecystitis in acute inflammation stage.Methods The clinical data of 169 patients with calculous cholecystitis in acute inflammation stage who underwent clipless LC from December 2008 to July 2010 were analyzed.Results All patients were successfully operated by LC except one case who suffered from gallbladder perforation and a conversion to open surgery was performed.The operation time ranged from 25-70 min（mean 38 min）.The blood loss ranged from 10-200 ml（mean 22 ml）.Peritoneal drainage was done in 38 patients,and the drainage time ranged from 1-6 d（mean 1.8 d）.The time to out-of-bed activity was at 2 h after operation and the hospitalization time was 3-7 d（mean 3.5 d）.There was no complication such as bile duct injury,hemorrhage,billiary leakage,and intra-abdominal infection.Conclusion With improvement of operator＇s experiences and skills,the clipless LC becomes feasible and safe for patients with calculous cholecystitis in acute inflammation stage.

关 键 词：急性炎症 腹腔镜胆囊切除术 胆囊结石 无异物 电凝钩 超声刀 

分 类 号：R657.4[医药卫生—外科学]