腹腔镜胆囊切除术治疗急性胆囊炎216例临床分析  

Laparoscopic cholecystectomy for acute cholecystitis: clinical analysis of 216 cases

作　　者：代军涛[1] 章平[1] 王庆[1] 沈伯明[1] 

机构地区：[1]复旦大学附属中山医院青浦分院普外科,上海201700

出　　处：《临床肝胆病杂志》2014年第7期647-649,共3页Journal of Clinical Hepatology

摘　　要：目的探讨腹腔镜胆囊切除术（LC）治疗急性胆囊炎的临床经验。方法回顾性分析复旦大学附属中山医院青浦分院2010年1月-2013年1月行LC的216例急性胆囊炎患者临床资料。手术采用气管插管全麻，常规采用三孔法，必要时增加-戳孔以利于操作。术后引流管放置1～3d．使用抗生素3～5d。观察手术时间、术后住院时间及术后并发症发生率。术后所有患者均随访至少半年。结果本组LC成功率87．0％（188／216），中转开腹率13．0％（28／216）。平均手术时间（62．004-11．27）min，平均住院时间（4．604-2．16）d，并发症发生率2．3％（5／216），患者均痊愈出院。随访期间均无其他并发症发生，术后恢复均良好。结论腹腔镜胆囊切除术治疗急性胆囊炎是安全可行的，正确处理好胆囊三角及良好的术中引流是手术成功的关键。Objective To investigate the clinical experience of laparoscopic cholecystectomy （LC） for acute eholecystitis. Methods A retrospective analysis was performed on the clinical records of 216 patients with acute cholecystitis who underwent LC in Qingpu Branch of Zhongsban Hospital, Fudan University from January 2010 to January 2013. LC was performed under intubation general anaesthesia, with three holes conventionally and four holes if necessary. After operation, the drainage tube was placed for 1 - 3 d, and antibiotics were administered for 3 - 5 d. The time of operation, length of postoperative hospital stay, and incidence of postoperative complications were determined. All patients were followed up for at least 0.5 year after operation. Results LC was successfully performed in 188 （ 87.0% ） of all patients ; 28 （ 13.0% ） of all patients were converted to open surgery. The mean time of operation was 62.00±11.27 min; the mean length of hospital stay was 4. 60±2.16 d; the incidence of postoperative complications was 2.3% （5/216）. All patients were cured and discharged. During follow - up, no patients developed other complications and all recovered well. Conclusion LC is safe and feasible in the treatment of acute cholecystitis. Correct manipulation of the Calot′s triangle and proper abdominal drainage are the key to successful operation.

关 键 词：胆囊切除术 腹腔镜 胆囊炎 急性 

分 类 号：R657.41[医药卫生—外科学]