胆囊管缝扎法在困难腹腔镜胆囊切除术的应用(附36例报告)  

Application of cystic duct ligation in 36 cases of laparoscopic cholecystectomy for difficult gallbladder

作　　者：王再兴[1] 曹钧[1] 马丹丹[1] 张杨[1] 张翌[1] 蔡逊[1] 

机构地区：[1]广州军区武汉总医院普通外科,武汉430070

出　　处：《腹部外科》2016年第5期343-346,共4页Journal of Abdominal Surgery

摘　　要：目的探讨"困难胆囊"行腹腔镜胆囊切除术中采用胆囊管缝扎法的安全性及有效性。方法回顾性分析我院自2014年12月至2015年12月收治的困难腹腔镜胆囊切除术使用胆囊管缝扎法处理的36例病人资料,其中急性化脓性胆囊炎伴胆囊周围严重粘连17例,胆囊管结石10例,短胆囊管4例,粗胆囊管4例,Mirizzi综合征1例。结果采用胆囊管缝扎法处理36例均成功施行腹腔镜胆囊切除术,无中转开腹。平均手术时间为(65±25)min,平均住院时间为(6.5±2.0)d,均痊愈出院。无胆管损伤、胆瘘、胃肠道损伤等并发症出现。结论腹腔镜胆囊切除术中采用胆囊管缝扎法在处理"困难胆囊"时,具有更安全有效的作用。Objective To explore the safety and effectiveness of the application of cystic duct ligation in laparoscopic cholecystectomy for difficult gallbladder. Methods The 36 cases of difficult gallbladder undergoing laparoscopic cholecystectomy from December 2014 to December 2015 were Pet- rospectively analyzed. There were 17 cases of acute suppurative cholecystitis with severe adhesion a- round gallbladder, 10 cases of cystic duct stones, 4 cases of short cystic duct, 4 cases of cystic duct di- ameter, and 1 case of Mirizzi syndrome. Results The laparoscopic cholecystectomy was successfully performed on 36 patients, and there was no conversion to open surgery. Mean operative time was 65 ± 25 min, and the average hospitalization time was 6. 5 ± 2. 0 days. All patients were cured and dis- charged. There was no bile duct injury, biliary fistula, gastrointestinal tract injury and other complica- tions. Conclusions The application of cystic duct ligation in laparoscopic cholecystectomy is effective and safe in the treatment of difficult gallbladder.

关 键 词：腹腔镜胆囊切除术 困难胆囊 胆囊管缝扎法 

分 类 号：R657.41[医药卫生—外科学]