腹腔镜外科杂志2025，Vol.30Issue(11)：836-838,849,4.DOI:10.13499/j.cnki.fqjwkzz.2025.11.836
腹腔镜胆囊次全切除术在困难胆囊切除中的应用
Application of laparoscopic subtotal cholecystectomy in difficult cholecystectomy
张桐 1张卫国1
作者信息
- 1. 青岛大学附属烟台毓璜顶医院肝胆外科,山东 烟台,264001
- 折叠
摘要
Abstract
Objective:To investigate the safety and feasibility of laparoscopic subtotal cholecystectomy in difficult cholecystec-tomy.Methods:A retrospective analysis was conducted on the clinical data of 39 patients who underwent laparoscopic subtotal cholecys-tectomy from Jan.2020 to Jan.2025.The perioperative conditions,complications,postoperative management,and follow-up data were re-corded and analyzed.Results:All 39 surgeries were successfully completed without conversion to open surgery.The median intraopera-tive blood loss was 5.0(2.0,10.0)mL,the average operation time was(88.97±23.60)min,and the mean postoperative hospital stay was(4.08±1.22)d.2 cases were complicated with common bile duct stones:one underwent preoperative endoscopic retrograde cholan-giopancreatography(ERCP)combined with endoscopic sphincterotomy(EST)for common bile duct stone extraction,and the other un-derwent intraoperative laparoscopic common bile duct exploration and primary suture.Postoperatively,4 patients developed bile leakage,which healed after adequate drainage;1 patient developed secondary common bile duct stones and was treated with ERCP combined with EST;1 patient was pathologically confirmed to have gallbladder cancer and underwent a second operation of robot-assisted laparoscopic radical resection(partial hepatectomy plus lymph node dissection at the porta hepatis).There were no cases of extrahepatic biliary tract injury or mortality.During the follow-up of 4 to 53 months,2 patients had recurrent choledocholithiasis at 5 months and 33 months post-operatively,respectively,and underwent stone removal via ERCP combined with EST.Conclusions:Laparoscopic subtotal cholecystecto-my is safe and feasible for difficult cholecystectomy.When the anatomical structure of the gallbladder triangle is complex and the critical view of safety cannot be achieved,laparoscopic subtotal cholecystectomy can reduce surgical difficulty and the risk of bile tract injury.关键词
胆囊炎/腹腔镜检查/胆囊次全切除术/治疗结果Key words
Cholecystitis/Laparoscopy/Subtotal cholecystectomy/Treatment outcome分类
医药卫生引用本文复制引用
张桐,张卫国..腹腔镜胆囊次全切除术在困难胆囊切除中的应用[J].腹腔镜外科杂志,2025,30(11):836-838,849,4.
