Zucker K A, Bailey R W, Flowers J
University of New Mexico School of Medicine, Albuquerque.
Surg Clin North Am. 1992 Oct;72(5):1045-67. doi: 10.1016/s0039-6109(16)45831-7.
Contrary to earlier predictions, it appears that acute cholecystitis should be considered a relative rather than an absolute contraindication to laparoscopic surgery. The most important parameter in determining the feasibility of attempting laparoscopic cholecystectomy in the setting of acute inflammation appears to be the experience of the surgeon. This also appears to be true when encountering individuals with elements of long-standing chronic cholecystitis. Although laparoscopic intervention in such patients is associated with a greater likelihood of conversion to open laparotomy, the incidence of major biliary and nonbiliary complications appears to be low. In addition, these patients enjoy the same benefits of laparoscopic surgery as those undergoing elective surgery.
与早期预测相反，急性胆囊炎似乎应被视为腹腔镜手术的相对而非绝对禁忌证。在急性炎症情况下，决定尝试腹腔镜胆囊切除术可行性的最重要参数似乎是外科医生的经验。在遇到有长期慢性胆囊炎因素的患者时，情况似乎也是如此。尽管对此类患者进行腹腔镜干预转为开腹手术的可能性更大，但严重胆道和非胆道并发症的发生率似乎较低。此外，这些患者与接受择期手术的患者一样享有腹腔镜手术的益处。
