Kinoshita M, Sumiyama Y
3rd Dept. of Surgery, Toho Univ. Sch. of Med.
Nihon Rinsho. 1993 Jul;51(7):1840-5.
During the past 5 years, traditional open cholecystectomy was performed on 344 patients with gallbladder stones at our hospital. Using the data obtained, we studied the indications and results of traditional open cholecystectomy. In the cases of gallbladder stones with a history of cholecystitis, cholecystectomy was performed as a rule by laparoscopic cholecystectomy. However, traditional open cholecystectomy was chosen in cases which were complicated by perforation, pericholecystic abscess, internal biliary fistra, cirrhosis, or suspicious carcinoma of gallbladder. Investigation of the time of operation revealed that early operation tended to be performed easily. However, cases with gallbladder stones were often complicated with carcinoma of alimentary tracts, therefore before operation we must examine the alimentary tract. Cases in which gallbladder could not be visualized under ERCP, and those accompanied by pericholecystic abscess under US were difficult to operate on by laparoscopic cholecystectomy. Thus many cases required laparotomy. Postoperative complications of open cholecystectomy were rare, it was concluded that traditional cholecystectomy is one of the most valuable procedures for the treatment of gallbladder stones.
在过去5年中，我院对344例胆囊结石患者实施了传统开放性胆囊切除术。利用所获得的数据，我们研究了传统开放性胆囊切除术的适应证和手术结果。对于有胆囊炎病史的胆囊结石病例，通常采用腹腔镜胆囊切除术进行胆囊切除。然而，对于并发穿孔、胆囊周围脓肿、胆内瘘、肝硬化或胆囊可疑癌的病例，则选择传统开放性胆囊切除术。对手术时间的调查显示，早期手术往往操作更容易。然而，胆囊结石病例常合并消化道癌，因此术前必须检查消化道。在ERCP下无法看清胆囊的病例，以及超声显示伴有胆囊周围脓肿的病例，很难通过腹腔镜胆囊切除术进行手术。因此，许多病例需要开腹手术。开放性胆囊切除术的术后并发症很少见，得出的结论是传统胆囊切除术是治疗胆囊结石最有价值的手术方法之一。
