腹腔镜手术治疗伴有Calot三角冰冻样粘连的急性坏疽性胆囊炎40例观察  

Observation of Surgery under Laparoscopes in Treatment of 40 Patients with Acute Gangrenous Cholecystitis Complicated by Calot Triangular Frozen Clay

作　　者：郑飞[1] 周文平[1] 

机构地区：[1]沈阳军区总医院肝胆外科,沈阳110016

出　　处：《解放军医药杂志》2015年第5期79-81,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：全军医学科技青年培育项目计划(13QNP004)

摘　　要：目的探讨伴有Calot三角冰冻样粘连的急性坏疽性胆囊炎行腹腔镜胆囊切除术的临床效果。方法沈阳军区总医院肝胆外科2008年8月—2013年8月治疗伴有Calot三角冰冻样粘连的急性坏疽性胆囊炎77例,依据手术方式分为观察组40例和对照组37例。观察组经腹腔镜实施胆囊切除术,对照组给予开腹手术。观察两组手术时间、术中出血量、引流量、下床活动时间、胃肠功能恢复时间及住院天数,比较两组并发症发生率。结果观察组手术时间、下床活动时间、胃肠功能恢复时间、住院天数均短于对照组,术中出血量和术后引流量均少于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论腹腔镜手术治疗伴有Calot三角冰冻样粘连的急性坏疽性胆囊炎损伤小,术后恢复快,但术式还应依据患者具体情况选择。Objective To investigate the clinical effects of subtotal cholecystectomy under laparoscopes in treatment of acute laparoscopic cholecystectomy complicated by Calot triangular frozen sticky clay. Methods A total of 77 patients with acute laparoscopic cholecystectomy complicated by Calot triangular frozen sticky clay during August 2008 and August 2013 were divided into study group（ n = 40） and control group（ n = 37） according to the operative methods.The study group was treated with laparoscopic cholecystectomy,while the control group was treated with open operation treatment. The operation time,volume of intraoperative blood loss,drainage volume,ambulatory time,recovery time of gastrointestinal function and hospitalization days in the two groups were observed,and the incidence rate of complications in the two groups was also compared. Results In study group,the operation time,ambulatory time,recovery time of gastrointestinal function and hospitalization days were significantly shorter,and volumes of intraoperative blood loss and postoperative drainage were significantly less than those in the control group（ P〈0. 05）. The difference in incidence rate of complications in the two groups was not statistically significant（ P〉0. 05）. Conclusion Laparoscopic operation in treatment of acute laparoscopic cholecystectomy complicated by Calot triangular frozen sticky clay can achieve the results of minor injury and quick recovery,but clinicians should select appropriate operative method based on the patients＇ conditions.

关 键 词：胆囊炎 急性 CALOT三角 胆囊切除术 腹腔镜 手术后并发症 

分 类 号：R657.41[医药卫生—外科学]