“高危”胆囊结石患者行腹腔镜胆囊切除术的要点分析——附115例报告

黄辉; 兑丹华; 蔡治方

doi:10.3969/j.issn.1001-5256.2014.05.012

“高危”胆囊结石患者行腹腔镜胆囊切除术的要点分析——附115例报告

DOI: 10.3969/j.issn.1001-5256.2014.05.012

遵义医学院附属医院肝胆外科

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中图分类号: R657.42
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出版历程
- 出版日期: 2014-05-20

Laparoscopic cholecystectomy for high-risk cholecystolithiasis: surgical key points and analysis of 115 cases

摘要

摘要:
目的探讨"高危"胆囊结石的疾病特点,总结其行腹腔镜胆囊切除术的诊治经验。方法对我院自2008年10月至2012年3月收治的115例"高危"胆囊结石患者行腹腔镜胆囊切除术的临床资料进行回顾性分析。结果本组115例患者,其中胆囊充满性型结石并胆囊萎缩、瓷化47例,急性化脓性及坏疽性胆囊炎42例,胆囊颈部结石嵌顿20例,胆囊管结石3例,胆囊十二指肠瘘2例,Mirizzi综合征1例。其中急诊腹腔镜胆囊切除术51例,其余均行择期手术,均康复出院。结论 "高危"胆囊结石患者,经积极术前准备,加强围手术期的处理,术中精准、规范及娴熟的手术操作,行腹腔镜胆囊切除术是可行的。
- 胆囊结石病 /
- 手术期间 /
- 胆囊切除术,腹腔镜
Abstract:
Objective To investigate the characteristics of high- risk cholecystolithiasis and summarize the experience of laparoscopic cholecystectomy for this disease. Methods A retrospective analysis was performed on the clinical data of 115 patients with high- risk cholecystolithiasis who underwent laparoscopic cholecystectomy in our hospital from October 2008 to March 2012. Results Of the 115 patients, 47 had stones filling the gallbladder as well as atrophy of the gallbladder and porcelain gallbladder, 42 had acute suppurative and gangrenous cholecystitis, 20 had stone incarceration in the gallbladder neck, 3 had cystic duct stones, 2 had cholecystoduodenal fistula, and 1 had Mirizzi syndrome; all patients were cured and discharged. Conclusion For patients with high- risk cholecystolithiasis, laparoscopic cholecystectomy is feasible, given active preoperative preparation, strengthened perioperative management, and accurate, standard, and skilled surgical operation.
- cholecystolithiasis /
- intraoperative period /
- cholecystectomy, laparoscopic

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参考文献(9)

[1]XU JM, CHENG NS, WU H, et al.Perioperative Treatment in Patients with High Risk Cholecystolithiasis[J].West China Med J, 2008, 23 (2) :235-236. (in Chinese) 徐建明, 程南生, 吴泓, 等.胆囊结石高危患者的围手术期处理[J].华西医学, 2008, 23 (2) :235-236.

[2]HU SY.Technique of laparoscope diagnosis and treatment[M].Ji'nan:Shandong Science and Technology Press, 2002:72-73. (in Chinese) 胡三元.腹腔镜临床诊治技术[M].济南:山东科学技术出版社, 2002:72-73.

[3]HUANG ZQ.Huang Zhiqiang Operative Surgery of the Blliary Tract[M].Ji'nan:Shandong Science and Technology Press, 2000:407. (in Chinese) 黄志强.黄志强胆道外科[M].济南:山东科学技术出版社, 2000:407.

[4]HUANG J, WANG ZF.Clinical observation and analysis of different surgical treetment of gallstone[J].J Clin Exp Med, 2012, 11 (13) :1060-1061. (in Chinese) 黄骏, 江志仿.不同手术方案治疗胆囊结石的疗效观察与分析[J].临床和实验医学杂志, 2012, 11 (13) :1060-1061.

[5]BLUMGART LH.Surgery of the liver, biliary tract, and pancreas[J].HUANG JF.Beijing:People’s Medical Publishing House, 2010:507. (in Chinese) BLUMGART LH.肝胆胰外科学[M].黄洁夫, 译.北京:人民卫生出版社, 2010:507.

[6] ERCUN XIONGCI.Knack&Pitfalls:Biliary Surgery[M].DONG JH.Beijing:People’s Medical Publishing House, 2010:119. (in Chinese) 二村雄次.要点与盲点:胆道外科[M].董家鸿, 译.北京:人民卫生出版社, 2010:119.

[7]YU DG, CAI ZF, GU J, et al.Laparoscopic cholecystectomy in the attractor of the clinical application[J].J Third Milit Med Univ, 2010, 32 (22) :2462-2463. (in Chinese) 余德刚, 蔡治方, 顾进, 等.腹腔镜胆囊切除术中吸引器的临床应用[J].第三军医大学学报, 2010, 32 (22) :2462-2463.

[8]CHEN QS, HE LG, LI FL, et al.Posterior Calot S triangle approach for three-port laparoscopic cholecystectomy[J].J Clin Hepatol, 2012, 28 (7) :516-518. (in Chinese) 陈钦涛, 何龙光, 黎福良, 等.胆囊后三角入路三孔法腹腔镜胆囊切除术[J].临床肝胆病杂志, 2012, 28 (7) :516-518.

[9]WANG QS.Laparoscopic cholecystectomy complications mechanism and prevention countermeasures[J].J Clin Hepatol, 2012, 28 (1) :11-13. (in Chinese) 王秋生.腹腔镜胆囊切除术并发症的发生机制与预防对策[J].临床肝胆病杂志, 2012, 28 (1) :11-13.

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