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[腹腔镜胆囊切除术。我们的经验]

[Laparoscopic cholecystectomy. Our experience].

作者信息

Occhioni G, Pinna R, Nonnis R, Padula G, Pisano I, Mastino G P, Sini G, Spissu M, Satta G, Trignano M

机构信息

Istituto di Patologia Speciale Chirurgica, Università degli Studi di Sassari.

出版信息

Minerva Chir. 1993 Oct 15;48(19):1047-51.

PMID:8309600
Abstract

This study analysed 90 cases of symptomatic cholelithiasis treated with laparoscopic cholecystectomy. 27% of the cases studied suffered from microlithiasis, 44% from multiple calculosis with calculi measuring 1 to 2 cm in diameter, 25% from single calculi measuring up to 4 cm in diameter, and 4% from a benign proliferative pathology of the cholecystic wall. Calculosis of the main biliary tract was also found in 3 patients and was treated by preoperative endoscopic papillosphincterotomy. In addition to routine tests and ultrasonography, endovenous cholangiography, or retrograde cholangiography (ERCP) in cases of suspected calculosis of the biliary tract, was always performed prior to surgery. Mean operating time was 60 min. Two procedures were converted into laparotomy due to laceration of the cystic artery. In one case laparotomy was performed on day two due to choleperitoneum following a lesion of the cystic duct. Pneumoperitoneum could not be performed in three cases. Mean hospital stay was 48 hours. No other intra- or postoperative complications were reported. These results support the opinion that laparoscopic cholecystectomy is a safe method, with few limitations and represents the treatment of choice in the therapy of symptomatic cholelithiasis.

摘要

本研究分析了90例接受腹腔镜胆囊切除术治疗的有症状胆结石患者。所研究的病例中,27%患有微结石症,44%患有直径为1至2厘米的多发结石症,25%患有直径达4厘米的单发结石,4%患有胆囊壁良性增生性病变。还发现3例患者存在主胆管结石症,并通过术前内镜乳头括约肌切开术进行了治疗。除常规检查和超声检查外,对于疑似胆管结石症的病例,术前总会进行静脉胆管造影或逆行胆管造影(ERCP)。平均手术时间为60分钟。由于胆囊动脉撕裂,有2例手术转为开腹手术。1例患者因胆囊管损伤后发生胆汁性腹膜炎,在第二天进行了开腹手术。3例患者无法进行气腹。平均住院时间为48小时。未报告其他术中或术后并发症。这些结果支持以下观点:腹腔镜胆囊切除术是一种安全的方法,局限性较少,是有症状胆结石治疗的首选方法。

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