急性胆囊炎胆囊穿刺引流术后早期切除的临床研究  

Clinical study of early laparoscopic cholecystectomy after gallbladder drainage for acute cholecystitis

作　　者：段俨芳 孙钧 王昊辰 刘崇忠 DUAN Yanfang;SUN Jun;WANG Haochen(Department of Hepatobiliary and Pancreatic Surgery,the Second Hospital of Shandong University,Jinan 250013,China)

机构地区：[1]山东大学第二医院肝胆胰外科,山东济南250013

出　　处：《腹腔镜外科杂志》2025年第2期115-118,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨急性胆囊炎行经皮经肝胆囊穿刺引流术(PTGD)后早期(1周内)行腹腔镜胆囊切除术(LC)的安全性与可行性。方法:回顾分析2022年1月至2024年9月收治的急性结石性胆囊炎患者的临床资料,11例患者在接受超声引导下PTGD术后1周内行LC。分析患者粘连分级、手术时间、术中出血量、术后住院时间、术后相关并发症等。结果:手术均在腹腔镜下完成,术中探查粘连均为轻度,手术时间平均(97.27±33.27)min,术中出血量10.00(10.00,50.00)mL。术后拔除引流管时间(3.09±0.83)d,术后无胆漏、延迟出血等并发症发生,住院11.00(8.00,14.00)d,均顺利治愈出院,未出现30 d内再入院病例。结论:急性胆囊炎患者行PTGD后早期(1周内)行LC是安全、可行的,具有粘连轻、出血少、住院时间短等优势。Objective:To investigate the safety and feasibility of early laparoscopic cholecystectomy(LC)within one week a fter percutaneous transhepatic gallbladder drainage(PTGD)for acute cholecystitis.Methods:Clinical data of patients with acute ca-lculous cholecystitis treated from Jan.2022 to Sep.2024 were retrospectively analyzed.Eleven patients underwent LC within one week a fter ultrasound-guided PTGD.Adhesion severity,operative time,intraoperative blood loss,postoperative hospital stay,and complications were evaluated.Results:All procedures were completed laparoscopically without conversion.Intraoperative adhesions were mild in all cases.The mean operative time was(97.27±33.27)min,and the median intraoperative blood loss was 10.00(10.00,50.00)mL,the average time for drainage tube removal was(3.09±0.83)d,no postoperative complications,such as bile leakage or delayed bleeding,occurred.The median postoperative hospital stay was 11.00(8.00,14.00)d,all patients recovered well and were discharged without r eadmission within 30 days.Conclusions:Early LC within one week after PTGD is safe and feasible for patients with acute cholecystitis.This approach offers advantages such as mild adhesions,minimal blood loss,and short hospital stay.

关 键 词：胆囊炎 急性 胆囊切除术 腹腔镜 经皮经肝胆囊穿刺引流术 手术时机 

分 类 号：R657.4[医药卫生—外科学]