Colonval P, Navez B, Cambier E, Richir C, de Pierpont B, Scohy J J, Guiot P
Service de Chirurgie Générale et Digestive, Hôpital Saint-Joseph, Gilly, Belgique.
Ann Chir. 1997;51(7):689-96.
From December 1989 to May 1995, a prospective study of laparoscopic cholecystectomy was carried out in our department, in order to assess the reliability and safety of this method in the case of acute cholecystitis. During this period, 1453 patients underwent laparoscopic cholecystectomy. Acute cholecystitis was diagnosed in 280 patients, based on clinical history and macroscopic lesions. Only 221 cases (15%) were included in the study after positive histology was obtained (M: 86; F: 135). The mean age was 62 years (20-90). Sixty-two patients (28%) were classified as ASA III and IV. The mean interval between the first symptoms and the operation was 9.9 days (1-53). The mean operating time was 130 minutes (45-420). Conversion to an open procedure was necessary in 22 cases (10%). The operative mortality was 0.9% (2 ASA IV patients) and the overall morbidity was 13.5%. A bile duct injury occurred in 0.4% of cases (1/221). In conclusion, laparoscopic cholecystectomy for acute cholecystitis is a safe procedure, when performed by operators experienced in laparoscopic surgery.
1989年12月至1995年5月，我们科室对腹腔镜胆囊切除术进行了一项前瞻性研究，以评估该方法在急性胆囊炎病例中的可靠性和安全性。在此期间，1453例患者接受了腹腔镜胆囊切除术。根据临床病史和宏观病变，280例患者被诊断为急性胆囊炎。在获得阳性组织学结果后，只有221例（15%）被纳入研究（男性86例；女性135例）。平均年龄为62岁（20 - 90岁）。62例患者（28%）被分类为ASA III级和IV级。首次症状出现至手术的平均间隔时间为9.9天（1 - 53天）。平均手术时间为130分钟（45 - 420分钟）。22例（10%）患者需要转为开放手术。手术死亡率为0.9%（2例ASA IV级患者），总体发病率为13.5%。0.4%的病例（1/221）发生了胆管损伤。总之，对于急性胆囊炎，由有腹腔镜手术经验的术者进行腹腔镜胆囊切除术是一种安全的手术方法。
