腹腔镜治疗慢性萎缩性结石性胆囊炎41例报告  

Laparoscopic Cholecystectomy and Laparoscopic Subtotal Cholecystectomy for Chronic Atrophic Cholecystolithiasis: a Report of 41 Cases

作　　者：刘志贤[1] 阚永丰[1] 陈波[1] 

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院普外科,北京100043

出　　处：《中国微创外科杂志》2014年第1期43-45,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨腹腔镜胆囊切除和次全切除术在治疗慢性萎缩性结石性胆囊炎中的可行性与手术技巧。方法2006年5月～2012年8月，腹腔镜治疗慢性萎缩性胆囊炎合并胆囊结石41例，其中26例行胆囊切除术（1aparoscopic cholecystectomy，LC），15例行胆囊次全切除术（1aparoscopic subtotal cholecystectomy，LSC）。结果 LC 26例中4例中转开腹（2例胆总管损伤，2例术中出血），手术时间（137．5±11．0）min，出血（177．7±36．5）ml，术后胆漏1例，继发性胆总管结石2例；LSC15例均成功，手术时间（99．9±10．1）min，出血（62．0±9．1）ml，术后胆漏1例，继发性胆总管结石1例。随访6—32个月，平均12．3月，均无明显消化道不良表现。结论腹腔镜治疗慢性萎缩性结石性胆囊炎是安全有效的。除了娴熟的手术技巧和精细、耐心的手术操作，根据患者实际情况，合理选择腹腔镜胆囊切除或次全切术式是手术成功的关键。Objective To explore the clinical feasibility and skills of laparoscopic cholecystectomy （LC） and laparoscopic subtotal cholecysteetomy （LSC） for the treatment of chronic atrophic cholecystolithiasis. Methods The clinical data of 41 cases with chronicatrophic cholecystolithiasis from May 2006 to August 2012 were retrospectively analyzed. Twenty six cases were treated by LC and 15 cases by LSC. Results Among the 26 cases by LC, four cases （including 2 cases of bile duct injury and 2 cases of intraoperative hemorrhage） were converted to open laparotomy. The operative time was （137.5 ± 11.0） min, and the intraoperative blood loss was （ 177.7 ± 36.5） ml. There were 1 case of postoperative bile duct leakage and 2 cases of secondary common bile duct stone. For the 15 cases by LSC, all surgeries were successful. The operative time was （99.9 ± 10.1 ） min, and intraoperative blood loss was （62.0± 9.1 ） ml. There were 1 case of postoperative bile duct leakage and 1 case of secondary common bile duct stone. All the cases were followed up for 6 to 32 months with an average of 12.3 months. No obvious dyspepsia was found. Conclusions Laparoscopy surgery is safe and feasible in the treatment of chronic atrophic cholecystolithiasis. The key to successful surgery are proficient skills and appropriate choice of laparoscopic cholecystectomy or laparoscopic subtotal cholecystectomy for the patients.

关 键 词：慢性萎缩性结石性胆囊炎 腹腔镜胆囊切除术 腹腔镜胆囊次全切除术 

分 类 号：R657.4[医药卫生—外科学]