Chng H C, Chia K H, Ng F C
Department of Surgery, Toa Payoh Hospital, Singapore.
Singapore Med J. 1993 Jun;34(3):205-7.
A retrospective analysis was done of 88 cases of laparoscopic cholecystectomy performed by the first author from November 1990 to March 1992 at the Toa Payoh Hospital. There were 61 female and 27 male patients; the average age was 47.1 years. The most common presenting symptom was biliary colic (85.3%), followed by acute cholecystitis (10.2%) and gallstone pancreatitis (4.5%). In the vast majority of patients, the diagnosis was established by ultrasound (96.6%) while the remainder was diagnosed by oral cholecystography (3.4%). The operation was performed using the usual 4 puncture approach with the single-handed technique of dissection. Antibiotic prophylaxis with a broad-spectrum agent was used in all patients and there was no incidence of wound infection. A low complication rate of 4.5% was experienced--consisting of 1 case each of subcutaneous emphysema, abdominal colic, fever and bile duct injury. There was no mortality in our series. The conversion rate was 9.1% and this was due to our policy of performing laparotomy whenever the safety of laparoscopic surgery was in doubt. The mean duration of postoperative hospitalisation was 3 days and 7 days after laparoscopic and converted cholecystectomies respectively. The majority of patients (61.4%) returned to work after 2 weeks.
对第一作者于1990年11月至1992年3月在大巴窑医院进行的88例腹腔镜胆囊切除术进行了回顾性分析。患者中女性61例，男性27例；平均年龄为47.1岁。最常见的症状是胆绞痛（85.3%），其次是急性胆囊炎（10.2%）和胆石性胰腺炎（4.5%）。绝大多数患者通过超声确诊（96.6%），其余通过口服胆囊造影确诊（3.4%）。手术采用常规的四孔法和单手解剖技术进行。所有患者均使用广谱抗生素进行预防性治疗，无伤口感染发生。并发症发生率较低，为4.5%，包括皮下气肿、腹部绞痛、发热和胆管损伤各1例。本系列无死亡病例。中转率为9.1%，这是由于我们在腹腔镜手术安全性存疑时进行剖腹手术的策略。腹腔镜胆囊切除术和中转开腹胆囊切除术后的平均住院时间分别为3天和7天。大多数患者（61.4%）在2周后恢复工作。
