Williams G B, Silverman R S
Department of Surgery, Northeastern Ohio Universities College of Medicine, Akron.
J Laparoendosc Surg. 1994 Apr;4(2):101-7. doi: 10.1089/lps.1994.4.101.
We reviewed 600 patients who underwent laparoscopic cholecystectomy (LC) in a teaching community hospital from May 1990 to August 1992. The safety, efficacy, morbidity, and mortality of LC, as performed by one surgeon or under his direct supervision, were studied. Five hundred forty-eight patients (91.3%) were treated electively; 52 (8.7%) were admitted for acute cholecystitis (41) or gallstone pancreatitis (11). Mean operating time was 54 min, with a range of 20 to 145 min. Twenty-four (4%) patients required conversion to traditional (open) cholecystectomy. Operative cholangiograms were completed in 106 patients. These revealed choledocholithiasis in 7. Five hundred thirty-seven patients (89.5%) were discharged within 24 h and 564 (94%) within 48 h. The overall morbidity of 9.2% compared favorably with both open and laparoscopic series previously reported. Three patients (0.5%) had small lacerations of the anterior wall of the common duct. Two were recognized and repaired immediately. The third patient came for treatment on the fifth postoperative day and was stented by a T-tube. There was 1 death in this group--a myocardial infarction on postoperative day 4.
我们回顾了1990年5月至1992年8月期间在一家教学社区医院接受腹腔镜胆囊切除术（LC）的600例患者。研究了由一名外科医生或在其直接监督下进行的LC的安全性、有效性、发病率和死亡率。548例患者（91.3%）为择期治疗；52例（8.7%）因急性胆囊炎（41例）或胆石性胰腺炎（11例）入院。平均手术时间为54分钟，范围为20至145分钟。24例（4%）患者需要转为传统（开放）胆囊切除术。106例患者完成了术中胆管造影。其中7例显示胆总管结石。537例患者（89.5%）在24小时内出院，564例（94%）在48小时内出院。9.2%的总体发病率与先前报道的开放手术和腹腔镜手术系列相比更具优势。3例患者（0.5%）胆总管前壁有小裂伤。2例被立即识别并修复。第3例患者在术后第5天前来治疗，通过T管置入支架。该组有1例死亡——术后第4天发生心肌梗死。
