临床肝胆病杂志
臨床肝膽病雜誌
림상간담병잡지
CHINESE JOURNAL OF CLINICAL HEPATOLOGY
2014年
7期
647-649
,共3页
代军涛%章平%王庆%沈伯明
代軍濤%章平%王慶%瀋伯明
대군도%장평%왕경%침백명
胆囊切除术,腹腔镜%胆囊炎,急性
膽囊切除術,腹腔鏡%膽囊炎,急性
담낭절제술,복강경%담낭염,급성
cholecystectomy,laparoscopic%cholecystitis,acute
目的：探讨腹腔镜胆囊切除术（LC）治疗急性胆囊炎的临床经验。方法回顾性分析复旦大学附属中山医院青浦分院2010年1月－2013年1月行LC的216例急性胆囊炎患者临床资料。手术采用气管插管全麻，常规采用三孔法，必要时增加一戳孔以利于操作。术后引流管放置1～3 d，使用抗生素3～5 d。观察手术时间、术后住院时间及术后并发症发生率。术后所有患者均随访至少半年。结果本组LC成功率87．0％（188／216），中转开腹率13．0％（28／216），平均手术时间（62．00±11．27）min，平均住院时间（4．60±2．16）d，并发症发生率2．3％（5／216），患者均痊愈出院。随访期间均无其他并发症发生，术后恢复均良好。结论腹腔镜胆囊切除术治疗急性胆囊炎是安全可行的，正确处理好胆囊三角及良好的术中引流是手术成功的关键。
目的：探討腹腔鏡膽囊切除術（LC）治療急性膽囊炎的臨床經驗。方法迴顧性分析複旦大學附屬中山醫院青浦分院2010年1月－2013年1月行LC的216例急性膽囊炎患者臨床資料。手術採用氣管插管全痳，常規採用三孔法，必要時增加一戳孔以利于操作。術後引流管放置1～3 d，使用抗生素3～5 d。觀察手術時間、術後住院時間及術後併髮癥髮生率。術後所有患者均隨訪至少半年。結果本組LC成功率87．0％（188／216），中轉開腹率13．0％（28／216），平均手術時間（62．00±11．27）min，平均住院時間（4．60±2．16）d，併髮癥髮生率2．3％（5／216），患者均痊愈齣院。隨訪期間均無其他併髮癥髮生，術後恢複均良好。結論腹腔鏡膽囊切除術治療急性膽囊炎是安全可行的，正確處理好膽囊三角及良好的術中引流是手術成功的關鍵。
목적：탐토복강경담낭절제술（LC）치료급성담낭염적림상경험。방법회고성분석복단대학부속중산의원청포분원2010년1월－2013년1월행LC적216례급성담낭염환자림상자료。수술채용기관삽관전마，상규채용삼공법，필요시증가일착공이리우조작。술후인류관방치1～3 d，사용항생소3～5 d。관찰수술시간、술후주원시간급술후병발증발생솔。술후소유환자균수방지소반년。결과본조LC성공솔87．0％（188／216），중전개복솔13．0％（28／216），평균수술시간（62．00±11．27）min，평균주원시간（4．60±2．16）d，병발증발생솔2．3％（5／216），환자균전유출원。수방기간균무기타병발증발생，술후회복균량호。결론복강경담낭절제술치료급성담낭염시안전가행적，정학처리호담낭삼각급량호적술중인류시수술성공적관건。
Objective To investigate the clinical experience of laparoscopic cholecystectomy (LC)for acute cholecystitis.Methods A retro-spective analysis was performed on the clinical records of 216 patients with acute cholecystitis who underwent LC in Qingpu Branch of Zhongs-han Hospital,Fudan University from January 2010 to January 2013.LC was performed under intubation general anaesthesia,with three holes conventionally and four holes if necessary.After operation,the drainage tube was placed for 1 -3 d,and antibiotics were administered for 3-5 d.The time of operation,length of postoperative hospital stay,and incidence of postoperative complications were determined.All patients were followed up for at least 0.5 year after operation.Results LC was successfully performed in 188 (87.0%)of all patients;28 (13.0%) of all patients were converted to open surgery.The mean time of operation was 62.00 ±11.27 min;the mean length of hospital stay was 4.60 ±2.16 d;the incidence of postoperative complications was 2.3%(5/216).All patients were cured and discharged.During follow-up,no patients developed other complications and all recovered well.Conclusion LC is safe and feasible in the treatment of acute cholecystitis.Cor-rect manipulation of the Calot's triangle and proper abdominal drainage are the key to successful operation.
