腹腔镜胆囊切除术治疗复杂胆囊的临床体会(附116例报告)  

The laparoscopic cholecystectomy for complicated cholecystectomy: a clinical analysis of 116 cases

作　　者：高骥[1] 白剑峰[1] 

机构地区：[1]南京医科大学第一附属医院,江苏南京210029

出　　处：《腹腔镜外科杂志》2016年第2期133-136,共4页Journal of Laparoscopic Surgery

摘　　要：目的：探讨并总结腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）治疗复杂胆囊的可行性、安全性及应用价值。方法：回顾分析2013年12月至2015年7月为116例复杂胆囊疾病患者行腹腔镜手术的临床资料。结果：116例患者中114例成功完成手术,2例中转开腹。手术时间45-135 min,平均（61.6±10.5）min;术中出血量40-500 ml,平均（70.0±11.3）ml;术后住院3-9 d,平均（3.6±0.2）d。术中发现胆管损伤6例,术后胆漏3例,对症处理,患者均顺利痊愈。术后均未出现出血、切口感染等并发症。结论：在严格掌握手术适应证、术者腹腔镜手术经验丰富的基础上,对于复杂胆囊良性疾病行LC是安全、可靠的,具有患者创伤小、术后康复快等优点,可达到其他手术方式的治疗效果,值得推广应用。Objective： To explore and conclude the feasibility,safety and value of the laparoscopic cholecystectomy（ LC） for complicated cholecystectomy. Methods： The clinical data of 116 patients with complicated benign gallbladder diseases undergoing LC from Dec. 2013 to Jul. 2015 were retrospectively analyzed. Results： Among all cases,114 cases of LC were performed successfully without conversion to open surgery. The other two cases were converted to open cholecystectomy. In all cases,operative time was（ 61. 6 ±10. 5） min（ range,45-135 min）; blood loss was（ 70. 0 ± 11. 3） ml（ range,40-500 ml）; postoperative hospital stay was（ 3. 6 ± 0. 2） d（ range,3-9 d）. Six cases were diagnosed as intraoperative bile duct injury,and three cases were postoperative bile leakage. After symptomatic treatment,the nine cases were cured. All patients were discharged successfully,and had good postoperative recovery,without bleeding,incision infection or other complications. Conclusions： For the complicated benign gallbladder diseases,on the base of strict indications and sufficient experience of laparoscopic surgery,the LC is safe and feasible,with advantages of minimal invasion and fast recovery. It can achieve the same treatment effect as other methods do,is worth being popularized.

关 键 词：胆囊切除术 腹腔镜 复杂 病例报告 

分 类 号：R657.4[医药卫生—外科学]