兰竹 周永碧 韦长征 400038 重庆，第三军医大学附属西南医院肝胆外科中心 中华消化内镜杂志 1999 0 16 5


    关键词：急性胆囊炎；腹腔镜胆囊切除术 期刊 zhxhnjzz 0 论 著 fur -->


    

摘要 目的 对腹腔镜胆囊切除术(LC)作为急性胆囊炎的治疗选择作出评估。方法 采用回顾性调查方法对LC治疗的207例胆囊结石伴急性胆囊炎患者的中转开腹、术后并发症情况及影响中转开腹的一些因素进行研究。结果 本组中转开腹率达32.3%，中转开腹的术后并发症发生率(20.9%)显著高于非中转开腹病例(5.7%)。影响中转开腹的因素有患者的性别，急性胆囊炎的胆囊状况，现病史长短，发病至手术的时间及外周血白细胞计数等。结论 对急性胆囊炎选择LC应慎重，对经判断中转风险较高的病例，不宜选择LC。

    

Evaluation of laparoscopic cholecystectomy for acute

    cholecystitis: a method of choice?

LAN Zhu, ZHOU Yongbi, WEI Changzheng.

    Hepatobiliary Surgery Center, Southwest Hospital, Third Military Medical University, Chongqing 400038

Abstract Objective Whether laparoscopic cholecystectomy(LC) is a treatment of choice for acute cholecystitis remains debatable. This study was attempted to make an evaluation on the topic. Methods 207 patients treated by LC for gallbladder stone with acute inflammation were retrospectively reviewed with emphasis on incidence of postoperative complication, rate of conversion to open cholecystectomy(OC) and factors influencing the conversion of approach. Results This series revealed that the rate of conversion to OC attained 32.3%; the incidence of complication reached 20.9%, significantly higher than that after conventional OC( 5.7% ). Pathology of the inflamed gallbladder ; time elapsed from onset ; length of present history ; severity of leucocytosis and even patient’s sex were taken into consideration as probable factors for the conversion . Conclusion In the case of acute cholecystitis adoption of LC should be scrutinized because LC is likely to be contraindicated in presence of the factors mentioned above.

    Key words Acute cholecystitis Laparoscopic cholecystectomy

对不伴急性胆囊炎的胆囊结石的治疗 ......