Groitl H, Stangl R, Scheele J, Gall F P
Chirurgische Universitätsklinik Erlangen, Bundesrepublik Deutschland.
Langenbecks Arch Chir Suppl Kongressbd. 1991:409-13.
From February 2, 1990 to June 15, 1991, a total of 160 patients were subjected to laparoscopic cholecystectomy. The procedure was successful in 150 patients, while in ten patients the procedure was converted to conventional cholecystectomy for the following reasons: suspected malignancy (2), cystic duct stone (1), dysfunction of equipment (2), adhesions (1), concomitant liver tumor (1), abscess in the hepatoduodenal ligament following endoscopic papillotomy (1), and chronic cholecystitis (2). Four patients developed substantial complications. Two patients developed biliary leakage requiring laparotomy and endoscopy placement of a nasobiliary tube in one case each. The other two patients developed intraabdominal bleeding that forced an emergency laparotomy in one case. With increasing experience in laparoscopic cholecystectomy, we would only consider a preoperative suspicion of malignancy as an absolute contraindication.
1990年2月2日至1991年6月15日，共有160例患者接受了腹腔镜胆囊切除术。150例患者手术成功，10例患者因以下原因转为传统胆囊切除术：怀疑恶性肿瘤（2例）、胆囊管结石（1例）、设备故障（2例）、粘连（1例）、合并肝肿瘤（1例）、内镜乳头切开术后肝十二指肠韧带脓肿（1例）以及慢性胆囊炎（2例）。4例患者出现严重并发症。2例患者发生胆漏，其中1例需要开腹手术，另1例需要内镜放置鼻胆管。另外2例患者发生腹腔内出血，其中1例需要紧急开腹手术。随着腹腔镜胆囊切除术经验的增加，我们仅将术前怀疑恶性肿瘤视为绝对禁忌证。
