Unger S W, Edelman D S, Scott J S, Unger H M
Department of Surgery, Mount Sinai Medical Center of Greater Miami, Florida.
Surg Laparosc Endosc. 1991 Mar;1(1):14-6.
Retrospective review of the first 210 patients treated by laparoscopic cholecystectomy revealed 55 patients (26%) with acute cholecystitis diagnosed preoperatively or intraoperatively. Average age was 52 years amongst 38 women and 17 men. Cardiac history was present in 4%, pulmonary disease was noted in 9%, and other significant medical history was found in 10%. Abnormal preoperative laboratory values (white blood cell count, liver function) were seen in 80%. Operations averaged 104 minutes. Dissection was performed with the potassium titanyl phosphate (KTP) laser in 9%, neodymium-doped yttrium aluminum garnet (Nd Yag) laser in 20%, and electrocautery alone in 71%. Average body habitus was 5 ft 9 in, 178 lb for men and 5 ft 5 in, 155 lb for women. Average length of stay was 2.6 days. Thirty-eight patients (69%) left the hospital in < 2 days. Postoperative complications included one case each of urinary retention, pneumonia, myocardial infarction, and three cases of postoperative fever. Drains were placed in 10 patients (18%). There was no mortality. Suggestions are made for technical considerations that make laparoscopic cholecystectomy a safe and efficient approach to acute cholecystitis.
对首批210例行腹腔镜胆囊切除术的患者进行回顾性研究发现，55例（26%）患者术前或术中被诊断为急性胆囊炎。其中38名女性和17名男性的平均年龄为52岁。4%的患者有心脏病史，9%的患者有肺部疾病，10%的患者有其他重大病史。80%的患者术前实验室检查值（白细胞计数、肝功能）异常。手术平均时长为104分钟。9%的手术使用磷酸钛钾（KTP）激光进行解剖，20%使用掺钕钇铝石榴石（Nd Yag）激光，71%仅使用电灼。男性的平均身高为5英尺9英寸（178磅），女性为5英尺5英寸（155磅）。平均住院时间为2.6天。38例（69%）患者在2天内出院。术后并发症包括1例尿潴留、1例肺炎、1例心肌梗死和3例术后发热。10例（18%）患者放置了引流管。无死亡病例。针对使腹腔镜胆囊切除术成为治疗急性胆囊炎安全有效方法的技术考量提出了建议。
