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[内镜手术方法治疗胆石症患者]

[Endovideosurgical methods at the treatment of patients with cholelithiasis].

作者信息

Lutsevich O E, Gordeev S A, Prokhorov Iu A

出版信息

Khirurgiia (Mosk). 2007(7):16-20.

Abstract

Experience of 10,046 laparoscopic cholecystectomies is analyzed. The were 8097 female and 1949 male patients aged 13 to 93 years. Complicated cholelithiasis was seen at 4310 (42.9%) patients including 792 patients with acute inflammation of gallbladder, 2375--with chronic empyema, 1143--with gallbladder hydrops. Choledocholithiasis was diagnosed at 502 patients, Mirizzi syndrome--at 8, biliodigestive fistulas--at 12, cancer of gall bladder--at 5 patients. Mini-invasive endoscopic methods were used at all the patients, conversion to open surgery was necessary at 23 cases. Average time of surgery was 20-35 min, hospital stay--1-6 days. Intra- and postoperative complications were diagnosed at 86 patients among the first 3000 procedures. Among successive 7000 operations (after development of prophylactic complex) there were only 3 cases of trocar puncture infection. There were 2 cases of lethal outcome due to pulmonary embolism and pancreonecrosis.

摘要

对10046例腹腔镜胆囊切除术的经验进行了分析。患者共8097名女性和1949名男性,年龄在13至93岁之间。4310例(42.9%)患者存在复杂胆结石,其中792例患有急性胆囊炎,2375例患有慢性脓胸,1143例患有胆囊积水。502例患者被诊断为胆总管结石,8例为Mirizzi综合征,12例为胆肠瘘,5例为胆囊癌。所有患者均采用微创内镜方法,23例需要转为开放手术。平均手术时间为20 - 35分钟,住院时间为1 - 6天。在前3000例手术中,86例患者被诊断出术中及术后并发症。在随后的7000例手术(在制定预防综合措施后)中,仅有3例套管针穿刺感染。有2例因肺栓塞和胰腺坏死导致死亡。

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