Donohue J H, Farnell M B, Grant C S, van Heerden J A, Wahlstrom H E, Sarr M G, Weaver A L, Ilstrup D M
Section of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1992 May;67(5):449-55. doi: 10.1016/s0025-6196(12)60390-5.
Prospective data and follow-up information were collected on the initial 200 patients who underwent laparoscopic cholecystectomy at the Mayo Clinic. The operation was completed laparoscopically in all but five patients, who required conversion to laparotomy because of dense scarring or stones in the common bile duct. The median surgical time was 85 minutes. The major postoperative complications were retained stones in the common bile duct (in seven patients), intraperitoneal hemorrhage that necessitated transfusion (in two patients), and intra-abdominal abscess and pulmonary infection (in one patient each). The median hospital stay was 1 day (range, 0 to 8 days), and the median times to full activity and normal employment were 8 days and 12 days, respectively. Laparoscopic cholecystectomy is associated with a low frequency of complications in most patients with symptomatic gallstones and allows a rapid return to normal activity. Currently, laparoscopic cholecystectomy is the treatment of choice for most patients with symptomatic cholelithiasis.
收集了梅奥诊所最初接受腹腔镜胆囊切除术的200例患者的前瞻性数据和随访信息。除5例患者外,所有患者均通过腹腔镜完成手术,这5例患者因严重瘢痕形成或胆总管结石而需要转为开腹手术。中位手术时间为85分钟。主要术后并发症包括胆总管残留结石(7例患者)、需要输血的腹腔内出血(2例患者)以及腹腔内脓肿和肺部感染(各1例患者)。中位住院时间为1天(范围为0至8天),完全恢复活动和正常工作的中位时间分别为8天和12天。对于大多数有症状胆结石患者,腹腔镜胆囊切除术的并发症发生率较低,并能使患者迅速恢复正常活动。目前,腹腔镜胆囊切除术是大多数有症状胆石症患者的首选治疗方法。