腹腔镜胆囊切除术450例临床分析  

A clinical analysis of 450 patients undergoing laparoscopic cholecystectomy

作　　者：陈伟 陈浩[2] 龚建平[2] 

机构地区：[1]重庆渝北区中医院,重庆401120 [2]重庆医科大学附属第二医院

出　　处：《腹腔镜外科杂志》2016年第9期688-691,共4页Journal of Laparoscopic Surgery

摘　　要：目的：总结腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）的经验教训,以减少手术并发症的发生。方法：回顾分析2012~2015年共450例LC患者的临床资料。结果：450例LC中,432例（96%）手术获得成功,18例（4%）中转开腹,其中胆囊三角充血水肿、解剖不清12例,胆囊床渗血3例,胆管损伤2例,右肝管畸形1例。手术时间35~130 min,平均（51.0±21.2）min。术后并发症包括：胆囊动脉钛夹松动出血2例,胆漏6例,肺部感染1例,心率失常1例,均通过相应手段治愈。无手术死亡病例。平均住院（4.2±1.2）d。结论：LC具有损伤小、痛苦少、康复快等优点,但也应重视其并发症,术前全面评估,根据术者的经验个体化选择,术中耐心仔细地操作,适时中转开腹,以减少并发症的发生。Objective： To sum up the clinical experience of laparoscopic cholecystectomy in order to reduce the postoperative complications. Methods： The clinical data of 450 patients who underwent laparoscopic cholecystectomy from 2012 to 2015 were retrospectively analyzed. Results： Among 450 cases,432 cases（96%） of laparoscopic cholecystectomy were successfully performed,while other 18 cases were converted to laparotomy（4%） for Calot triangle edema and vague anatomy（12 cases）,errhysis in gallbladder bed（3 cases）,bile duct injury（2 cases） and right hepatic duct malformation（ 1 case）. The operation time ranged from 35 to 130 min,and the average was（ 51. 0 ± 21. 2） min. Postoperative complications included bleeding because of the cystic artery clip loosening（2 cases）,bile leakage（6 cases）,lung infection（1 case） and arrhythmia（1 case）,all of them were treated respectively and finally cured.No death cases were found. The average hospitalization time was（4. 2 ± 1. 2） d. Conclusions： Laparoscopic cholecystectomy has advantages of mini-invasion,little pain and rapid recovery. The complications of laparoscopic cholecystectomy should be highlighted. Comprehensive preoperative assessment,individualization according to experience of surgeons,careful and patient operation,and converting to laparotomy when necessary,all of these can decrease the complications.

关 键 词：胆囊切除术 腹腔镜 适应证 并发症 

分 类 号：R657.4[医药卫生—外科学]