摘要
目的探讨腹腔镜胆囊切除术治疗合并肝硬化的胆囊疾病的方法与疗效。方法回顾分析2000年1月至2004年12月对118例肝硬化合并胆囊结石病人实施腹腔镜胆囊切除术(LC)的临床资料。结果Child肝功能分级A级76例,B级42例。腹腔镜下成功切除胆囊85例(72·1%),胆囊次全切除28例(23·7%),1例因结石嵌顿胆囊三角胆囊动脉出血,4例(4·2%)因胆囊床出血而中转开腹。手术时间(52·6±15·2)min,术中出血(75·5±20·7)mL。术后腹壁戳孔处出血3例,腹腔引流出大量腹水14例。无腹腔感染、肺感染及肝功能衰竭等严重并发症。术后住院时间(7·5±2·4)d。结论对肝硬化(ChildA、B级)合并胆囊疾患的病人行LC手术是可行的,但如何控制术中出血特别是胆囊床部位的出血是手术难点,应严格掌握手术适应证。为减少并发症,应适当放宽中转开腹指征。
Objective To investigate the significance of laparoscopic cholesystectomy （LC） in the cirrhosis patients with gall bladder disease. Methods From January 2000 to December 2004,118 cases with cholecystolithiasis associated with liver cirrhosis received LC. Their clinical data were analyzed retrospectively. Results Eighty-five cases receipted LC successfully ;28 cases were undertook subtotal cholecystectomy, and 5 cases did conversion. No severe complications developed. The post-operative hospital stay was （7.5 ± 2. 4） d. Conclusion LC is safe and effective for the treatment of patients associated with liver cirrhosis. It is very important to avoid hemorrhage of cholecyst bed. In order to minimize the complication rate, the conversion indication should be broadened.
出处
《中国实用外科杂志》
CSCD
北大核心
2006年第7期514-516,共3页
Chinese Journal of Practical Surgery
关键词
腹腔镜
胆囊切除术
肝硬化
Laparoscope
Cholecystectomy
Liver cirrhosis
作者简介
E-mail：liza-zhang@sohu．com
