Lujan J A, Parrilla P, Robles R, Torralba J A, Garcia Ayllon J, Liron R, Sanchez-Bueno F
Department of General Surgery, Virgen de la Arrixaca University Hospital, University of Murcia, Spain.
J Am Coll Surg. 1995 Jul;181(1):75-7.
Laparoscopic cholecystectomy has several advantages over traditional cholecystectomy, which make it the treatment of choice for patients with uncomplicated biliary lithiasis. However, in patients with acute cholecystitis, the role of this technique remains controversial and some clinicians regard this condition as a contraindication to laparoscopic cholecystectomy.
Between June, 1991 and July, 1993, a total of 259 patients with cholelithiasis underwent laparoscopic cholecystectomy at the "Virgen de la Arrixaca" University Hospital. Of these patients, 60 underwent laparoscopic cholecystectomy for acute cholecystitis.
Conversion to laparotomy was necessary in eight patients (13 percent). Mean operating time was 83 minutes (range, 45 to 180 minutes). Overall mean hospital stay (laparoscopy and conversions) was 3.1 days (range, one to nine days). There was no mortality or injury to the common bile duct in our series.
We believe that laparoscopic cholecystectomy in patients with acute cholecystitis is a safe and effective procedure, in which the patient can benefit from the advantages of laparoscopic surgery without an increase in mortality and morbidity rates.
腹腔镜胆囊切除术相较于传统胆囊切除术具有多项优势,这使其成为单纯性胆石症患者的首选治疗方法。然而,对于急性胆囊炎患者,该技术的作用仍存在争议,一些临床医生将这种情况视为腹腔镜胆囊切除术的禁忌证。
在1991年6月至1993年7月期间,共有259例胆石症患者在“比根德拉阿里克斯卡”大学医院接受了腹腔镜胆囊切除术。其中,60例患者因急性胆囊炎接受了腹腔镜胆囊切除术。
8例患者(13%)需要转为开腹手术。平均手术时间为83分钟(范围为45至180分钟)。总体平均住院时间(腹腔镜手术和转为开腹手术的患者)为3.1天(范围为1至9天)。我们的系列研究中没有死亡病例,也没有胆总管损伤。
我们认为,急性胆囊炎患者的腹腔镜胆囊切除术是一种安全有效的手术,患者可以从腹腔镜手术的优势中获益,而不会增加死亡率和发病率。