摘要
Abstract
Objective: An acute attack of cholecystopathy can cause gallbladder abscess or gangrene, to discusses the strategies for treatment of inflammatory infection of severe acute cholecystopathy through two operation holes.Method: There were four steps in LC. The first step was to separate cholecyst from the adhesions around to have a preliminary understanding of Calot triangle or important content, when the cholecyst was under tension. Then, an artificial window to be opened in the cholecyst wall, and a pressure-relief aspirator to be placed into it to aspirate all the liquid content. The third step was to cut the serosa of the cystic duct near the Hartmann’s pouch, and to use an aspirator to aspirate the cystic duct until the cystic duct and the cystic artery reveal. The fourth step was to separate the cholecyst bed by electrotomy near the cholecyst wall quickly, and to press immediately the cholecyst bed with gauze. The last step was to stop bleeding from top to bottom. Result: All 35 cases of cholecystectomy through two holes were successful. 5 cases were under cholangiography. 3 cases were operated together with Choledochoscope Choledocholithotomy. During the operation, bleeding was 30-650 mL, time was about 50-130 minutes. Conclusion: The operation of cholecystectomy of suppurative and serious cholecystitis is different from normal LC in the aspects of method and program, in expression of high swelling, lard-bucket, esay bleeding, blurring of anatomy. The inflammatory infection of cystic duct is moderate. Although it may cause severe infection, for an experienced laparoscopic operator, cholecystectomy with laparoscope can be used.关键词
坏疽重症性胆囊炎/两操作孔/腹腔镜胆囊切除术/策略Key words
Suppurative and serious cholecystitis/Two operation holes/Cholecystectomy with laparoscope/Strategy
