新医学Issue(5)：312-315,4.DOI:10.3969/g.issn.0253-9802.2014.05.009
不解剖胆囊三角并保留部分胆囊壁的腹腔镜胆囊切除术
Laparoscopic cholecystectomy with undissected calot triangle and remained partial gall bladder wall
刘国生 1蔺晖琦 1徐恒 1尹照成 1黄眷杰 1许瑞云2
作者信息
- 1. 523660 东莞，东莞清溪医院外一科
- 2. 510630 广州，中山大学附属第三医院肝胆外科
- 折叠
摘要
Abstract
Objective To evaluate the curative effect of laparoscopic cholecystectomy (LC)with undissected calot triangle and remained partial gall bladder wall in patients with chronic cholecystitis/cholecys-tolithiasis combined with highly fibrotic gall bladder wall. Methods Eighty-nine cases of chronic cholecysti-tis/cholecystolithiasis combined with highly fibrotic gall bladder wall received LC of four hole method. During operation,retrograde method was used,with undissected calot triangles and remained partial gall bladder walls. The effect of this surgical method was analyzed. Results Seventy-eight cases (87.6%)of all patients underwent the operation successfully. The operating time was 30~90 min,with an average of 45 min. Bleeding amount was 20~50 ml,with an average of 30 ml. The hospitalized time was 4~7 d,with an average of 5 d.Seven cases with opaque operative field underwent LC with ultrasound assistance successfully. Three cases were converted to open cholecystectomy because of tissue adhesion. One case with iatrogenic common bile duct inju-ry converted to open cholecystectomy,and then received bile total pipe anastomosis and T-tube drainage. Three of 85 cases only received LC with mild biliary fistula and were cured by the continuous negative pressure drain-age. 3 cases with transient mild diarrhea were resolved spontaneously in 1 to 3 months after operation. All pa-tients were cured without other surgical complications. Conclusions LC with undissected calot triangle and re-mained partial gall bladder wall can effectively treat patients with chronic cholecystitis/cholecystolithiasis com-bined with highly fibrotic gall bladder wall,but open cholecystectomy should be considered if there are serious tissue adhesions.关键词
腹腔镜胆囊切除术/Calot三角/慢性胆囊炎/胆囊结石Key words
Laparoscopic cholecystectomy/Calot triangle/Chronic cholecystitis/Cholecystolithiasis引用本文复制引用
刘国生,蔺晖琦,徐恒,尹照成,黄眷杰,许瑞云..不解剖胆囊三角并保留部分胆囊壁的腹腔镜胆囊切除术[J].新医学,2014,(5):312-315,4.
