腹腔镜下处理复杂胆囊炎伴胆囊结石94例临床分析  

Clinical experience of laparoscopic treatment on cholecystitis complicated with gallstones report of clinical analysis of 94 cases

作　　者：邬叶锋[1] 赵登秋[1] 

机构地区：[1]201599,上海市第六人民医院金山分院普外科

出　　处：《中国综合临床》2015年第6期-,共3页Clinical Medicine of China

摘　　要：目的 总结腹腔镜下处理复杂胆囊炎伴胆囊结石的手术经验,为临床复杂困难胆囊行腹腔镜切除术提供参考.方法 回顾总结2008年1月至2014年12月间94例复杂病例的腹腔镜胆囊切除手术处理方式.结果 94例患者包括胆囊周围严重粘连17例,胆囊严重萎缩9例,胆囊壶腹部或胆囊管结石嵌顿39例,急性坏疽性胆囊炎伴胆囊结石11例,胆囊三角区解剖不清14例,胆囊结石合并血吸虫性或肝炎后肝硬化、肝体积变异19例,其中部分病例上述两种或以上因素并存.顺利实施腹腔镜下胆囊切除91例(其中胆囊大部切除术4例),中转开腹3例.无严重并发症与死亡病例.结论 针对复杂胆囊结石出现的不同术中情况,采用不同的手术操作技巧与处理方法,可在腹腔镜下完成手术.Objective To summary clinical experience of laparoscopic treatment of cholecystitis with cholecystolithiasis complicated,in order to provide reference for clinical difficult laparosco-pic resection of gallbladder.Methods Reviewing the operation treatment of laparoscopic cholecystectomy on 94 complex cases of resection during January 2008 to December 2014.Results The 94 patients included 17 cases with severe adhesion around gallbladder,9 cases with gallbladder atrophy,39 cases with gallbladder ampulla and cystic duct stone incarceration,11 cases with acute gangrenous cholecystitis with gallbladder stones,14 cases with gallbladder triangle anatomy is not clearing and 19 cases with gallbladder stones with schistosomial cirrhosis or liver volume variation.Some cases were with the two or more kinds gallbladder stone.There were 91 cases with successful implementation of the laparoscopic cholecystectomy,4 of 91 cases were treated with subtotal cholecystectomy,and 3 cases were converted to open cholecystectomy.There were no cases with serious complications or even deaths.Conclusion Regarding of the complex gallbladder stones appear different situation in operation,we can complete the operation by using different operation method and treatment method in laparoscopic.

关 键 词：腹腔镜 胆囊切除术 胆囊结石 

分 类 号：R5[医药卫生—内科学]