CAJ | 학술논문

目的探讨腹腔镜胆囊切除术（LC）在急性结石性胆囊炎中的临床应用。方法将2011年7月～2013年4月期间来我院就诊的165例急性结石性胆囊炎患者随机分为腹腔镜胆囊切除术组（LC，n=105）和常规开腹胆囊切除术组（OC，n=60）。对比研究两组的手术时间，失血量，并发症，平均住院时间及住院费用等，并对急性结石性胆囊炎行腹腔镜胆囊切除的手术技巧进行探讨。结果LC组无中转开腹，2例术后第2天出现胆漏，给予负压引流治愈，其余103例痊愈出院；OC组中1例术后第2天出现腹腔出血，经保守治疗痊愈。结论在急性胆囊炎腹腔镜胆囊切除的处理中，完善术前检查，重视术中胆道造影，仔细解剖胆囊三角，弄清“三管一壶腹”是在急性胆囊炎腹腔镜胆囊切除术中减少并发症及手术安全的关键。
목적탐토복강경담낭절제술（LC）재급성결석성담낭염중적림상응용。방법장2011년7월～2013년4월기간래아원취진적165례급성결석성담낭염환자수궤분위복강경담낭절제술조（LC，n=105）화상규개복담낭절제술조（OC，n=60）。대비연구량조적수술시간，실혈량，병발증，평균주원시간급주원비용등，병대급성결석성담낭염행복강경담낭절제적수술기교진행탐토。결과LC조무중전개복，2례술후제2천출현담루，급여부압인류치유，기여103례전유출원；OC조중1례술후제2천출현복강출혈，경보수치료전유。결론재급성담낭염복강경담낭절제적처리중，완선술전검사，중시술중담도조영，자세해부담낭삼각，롱청“삼관일호복”시재급성담낭염복강경담낭절제술중감소병발증급수술안전적관건。
Objective To explore the clinic application of laparoscopic cholecystectomy in acute alculus cholecystiti. Methods 165 patients with acute alculus cholecystiti were treated in our department from July 2011 to April 2013,they were randomLy divided into 2 groups: laparoscopic cholecystectomy group(LC group,105 patients)and openly cholecystectomy group(OC group, 60 patients).We compare the operation time,blood loss,complications,average length of hospital stay and cost between two groups.We also explore the operation skills of laparoscopic cholecystectomy in acute alculus cholecystiti. Results In LC group,bile leakage occurred in two patients and were cured after negative pressure drainage, no open cholecystectomy happened.In OC group,Intraperitoneal hemorrhage occurred in one patient and were cured after conservative treatment. Conclusion For the sake of operation safe and less complications in acute alculus cholecystiti treated by laparoscopic cholecystectomy,completely preoperative check, intraoperative cholangiography and carefully separated of the Calot's triangle,cystic duct,hepatic duct, common bile duct and gallbladder ampulla are crucial.