腹腔镜胆囊切除术后残余胆囊的腹腔镜再手术治疗体会  

Laparoscopic operation in the treatment of residual gallbladder after laparoscopic cholecystectomy

作　　者：姜世涛[1] 龚仁华[1] 但震宇[1] 郑多安 盛华嵩[1] 

机构地区：[1]武警安徽省总队医院,安徽合肥230000

出　　处：《腹腔镜外科杂志》2015年第9期670-672,共3页Journal of Laparoscopic Surgery

摘　　要：目的：探讨残余胆囊再次行腹腔镜切除术的可行性及手术技巧。方法：回顾分析2010年6月至2014年8月收集的18例病例,其中2例合并胆总管结石。患者均经历一次腹腔镜胆囊切除术,术后出现残余胆囊结石,并出现胆囊炎症状,再次行腹腔镜残余胆囊切除术（2例胆总管结石同时行胆总管切开取石术）。结果：18例均顺利行腹腔镜残余胆囊切除术,手术时间平均（55.3±0.6）min,术中出血量平均（35.5±0.3）ml,患者均于术后次日下床并进食低脂流食,术后恢复良好,患者术前主诉的症状均消失,平均住院（3.8±0.3）d,随访10例患者1~6个月,无胆漏、黄疸等并发症发生。结论：腹腔镜手术用于腹腔镜胆囊切除术后残余胆囊结石伴胆囊炎是安全、有效的治疗方法,值得推广应用。Objective： To investigate the feasibility and operation skill of laparoscopic surgery used in residual gallbladder after laparoscopic cholecystectomy. Methods： The clinical data of 18 patients from Jun. 2010 to Aug. 2014 were analyzed retrospectively,including 2 cases with common bile duct stones. All patients underwent laparoscopic cholecystectomy,residual stone and cholecystitis happened again and underwent re-laparoscopic operation（ 2 cases of common bile duct stones underwent choledocholithotomy）. Results：All cases were successfully performed laparoscopic resection of residual gallbladder,the average operation time was（ 55. 3 ± 0. 6） min,the amount of intraoperative bleeding was（ 35. 5 ± 0. 3） ml. All patients recovered well,got out of bed and ate low-fat liquid diet in the next day after surgery,the preoperative symptoms disappeared after operation. The average hospital stay was（ 3. 8 ± 0. 3） d. The followup was from the first month to sixth month after operation,and there were no complications such as biliary leakage or jaundice. Conclusions： Laparoscopic surgery is feasible and safe for patients with residual gallbladder after laparoscopic cholecystectomy. It is worthy of popularization and application.

关 键 词：残余胆囊 胆囊切除术 腹腔镜 腹腔镜检查 

分 类 号：R657.4[医药卫生—外科学]