摘要
目的 探讨合并肝硬化患者腹腔镜胆囊切除 (LC)的可行性与技术特点。方法 对接受LC的10 0例合并肝硬化患者的治疗结果进行回顾性分析。结果 LC成功 94例 ,中转 6例。中转原因 :结石嵌顿、Calot三角区致密粘连 3例 ;术中出血 ,镜下止血困难 2例 ;术中发现胆道变异 1例。LC平均手术时间 (5 4 .6±15 .7)min ,术中平均出血 (6 2 .5± 2 1.2 )ml。术中无损伤 ,术后出血 1例 ,肺部感染 1例 ,泌尿系感染 1例 ,轻度肝性脑病 1例 ,腹水增多 4例。无肝功能衰竭等严重并发症 ,患者均治愈出院 ,术后平均住院 (5 .3± 2 .2 )d。结论 合并肝硬化患者LC是相对安全的 ,掌握手术的技术特点 。
Objective To evaluate the feasibility and technical characteristics of laparoscopic cheolecystectomy(LC) in cirrhotic patients. Methods The results of 100 LC cases in cirrhotic patients were retrospectively analyzed. Results LC was successfully performed in 94 patients,6 cases were converted to laparotomy for open cholecystectomy because of stone incarceration and dense adhesion of Calot triangle in 3 cases, difficult management of bleeding under laparoscopy in 2 cases and anatomic variation of external hepatic biliary duct in 1 case. The average operation time of LC was(54.6±15.7)min and the average blood loss was(62.5±21.2)ml. There was no injury during the operation. Postoperative complications included 1 case of bleeding,1 case of respiratory tract infection,1 case of urinary tract infection,1 case of slight hepatic encephalopathy and 4 cases of ascite increase. All patients recovered smoothly and discharged from hospital within(5.3±2.2)days after LC. Conclusion LC for cirrhotic patients is relatively safe. It is important to know the technical characteristics and to pay attention to the peri-operation management.
出处
《中国综合临床》
北大核心
2004年第7期634-636,共3页
Clinical Medicine of China
关键词
肝硬化
腹腔镜
胆囊结石
胆囊切除术
Cirrhosis
Laparoscopic
Gallbladder stone
Cholecystectomy
