Z'graggen K, Metzger A, Birrer S, Klaiber C
Chirurgische Klinik, Tiefenauspital Bern.
Chirurg. 1995 Apr;66(4):366-70.
Between November 1989 and May 1994 103 laparoscopic cholecystectomies were performed for acute cholecystitis. Conversion rate was 4.9%. Mortality was 0. Postoperative morbidity was 10.7% (6.8% local complications, 3.9% systemic complications). None of the complications lead to a reoperation, no injuries of the common bile duct occurred. These results compare favorably to randomized studies of open cholecystectomy and to published result of laparoscopic cholecystectomy for acute cholecystitis. Main determining factor for technical difficulty of the operation was the lapse of time between onset of symptoms and operation. This is expressed in statistically different mean operative times in patients with short (1-6 days) and long (7-14; 15-21 days) clinical history of acute cholecystitis. We therefore conclude that early surgery, in selected cases even emergency surgery is indicated and that in expert hands laparoscopic cholecystectomy can be the treatment of choice for acute cholecystitis.
1989年11月至1994年5月期间，对103例急性胆囊炎患者实施了腹腔镜胆囊切除术。中转开腹率为4.9%。死亡率为0。术后发病率为10.7%（局部并发症6.8%，全身并发症3.9%）。所有并发症均未导致再次手术，未发生胆总管损伤。这些结果与开腹胆囊切除术的随机研究以及已发表的腹腔镜胆囊切除术治疗急性胆囊炎的结果相比更具优势。手术技术难度的主要决定因素是症状出现与手术之间的时间间隔。这在急性胆囊炎临床病程短（1 - 6天）和长（7 - 14天；15 - 21天）的患者平均手术时间上有统计学差异体现。因此，我们得出结论，在某些病例中早期手术甚至急诊手术是必要的，并且在专家手中，腹腔镜胆囊切除术可以成为急性胆囊炎的首选治疗方法。
