Objective To investigate the clinical effect of laparoscopic cholecystectomy ( LC) in the treatment of acute calculous cholecystitis. Methods A retrospective analysis was performed for the clinical data of 86 patients with acute calculous cholecystitis who underwent LC in Department of General Surgery in Nanjing Jiangning Hospital Affiliated to Nanjing Medical University from May 2016 to May 2017. Results The surgery was performed within 1 week after disease onset, with a time of operation of 60-130 minutes ( mean 75. 5 ± 10. 5 minutes) , an intraoperative blood loss of 40-200 ml ( mean 70 ± 11. 2 ml) , and a length of postoperative hospital stay of 3-14 days ( mean6 ± 1. 5 days) . Of all 86 patients, 40 had simple acute cholecystitis, 38 had acute pyogenic cholecystitis, 5 had acute gangrenous cholecystitis, and 3 had an acute exacerbation of chronic cholecystitis; 6 patients were converted to open surgery, and 80 underwent a successful surgery, among whom one underwent primary duodenal repair due to cholecystoduodenal fistula. Intraoperative cholangiography was performed for 20 patients, among whom one was found to have common bile duct stones, and then common bile duct exploration and T-tube drainage were performed; two patients were found to have bile duct injury, which was repaired during surgery, and T-tube drainage was performed for one patient and primary suture was performed for the other patient. One patient experienced bile leakage after surgery and was cured after conservative treatment; all the other patients had no complications such as bile leakage and bleeding. Conclusion For acute calculous cholecystitis, indications should be strictly followed and laparoscopy should be adequately mastered. LC is safe and effective with little trauma.
[1]NITZAN O, BRODSKY Y, EDELSTEIN H, et al.Microbiologic data in acute cholecystitis:ten years'experience from bile cultures obtained during percutaneouscholecystostomy[J].Surg Infect (Larchmt) , 2017, 18 (3) :345-349.
|
[2]XU J, DONG JJ.Reasonable options and controversies of laparoscopic treatment for acute cholecystitis[J].Chin J Prac Surg, 2015, 35 (5) :482-486. (in Chinese) 许军, 董杰杰.腹腔镜手术治疗急性胆囊炎合理选择及争议[J].中国实用外科杂志, 2015, 35 (5) :482-486.
|
[3]MENG FL, DU GJ, WANG DK, et al.Analysis of clinical therapeutic effect of laparoscope and laparotomy for acute cholecystitis[J].Chin Prac Med, 2017, 12 (14) :38-40. (in Chinese) 孟飞龙, 杜冠杰, 王登科, 等.腹腔镜与开腹手术对急性胆囊炎的临床治疗效果分析[J].中国实用医药, 2017, 12 (14) :38-40.
|
[4]HUANG GR, WEI XY, ZHOU CC, et al.Application value of Calot triangle hollowing-out maneuver in laparoscopic cholecystectomy[J].Chin J Dig Surg, 2017, 16 (9) :963-966. (in Chinese) 黄国荣, 魏小勇, 周存才, 等.胆囊三角掏空法在腹腔镜胆囊切除术中的应用价值[J].中华消化外科杂志, 2017, 16 (9) :963-966.
|
[5]UYSAL E, TUREL KS, SIPAHI M, et al.Comparison of early and interval laparoscopic cholecystectomy for treatment of acute cholecystitis.which is Better?A multicentered study[J].Surg Laparosc Endosc Percutan Tech, 2016, 26 (6) :e117-e121.
|
[6]RAJCOK M, BAK V, DANIHEL L, et al.Early versus delayed laparoscopic cholecystectomy in treatment of acute cholecystitis[J].Bratisl Lek Listy, 2016, 117 (6) :328-331.
|
[7]ZHENG QZ, ZHANG JF, XIE ZR, et al.Analysis of influencing factors for conversion of laparoscopic cholecystectomy to open surgery[J].J Clin Hepatol, 2015, 31 (10) :1671-1674. (in Chinese) 郑奇志, 张剑锋, 谢湛荣, 等.腹腔镜胆囊切除术中转开腹的影响因素分析[J].临床肝胆病杂志, 2015, 31 (10) :1671-1674.
|
[8]WANG CJ, LI H, LIU LM.Analysis of laparoscopic cholecystectomy surgery by the curettage and suction in treatment of 278 cases of patients with acute cholecystitis[J].China Foreign Med Treatment, 2017, 36 (3) :83-84, 87. (in Chinese) 王朝江, 李豪, 刘立明.刮吸法腹腔镜胆囊切除术治疗急性胆囊炎278例治疗分析[J].中外医疗, 2017, 36 (3) :83-84, 87.
|
[9]GIULEA C, ENCIU O, BIRCA T, et al.Selective intraoperative cholangiography in laparoscopic cholecystectomy[J].Chirurgia (Bucur) , 2016, 111 (1) :26-32.
|
[10]HUANG W, CHEN Y.Preventive measures for bile duct injury and bleeding during laparoscopic cholecystectomy[J].J Clin Hepatol, 2016, 32 (5) :911-913. (in Chinese) 黄炜, 陈怡.腹腔镜胆囊切除术中预防胆道损伤及出血的方法探讨[J].临床肝胆病杂志, 2016, 32 (5) :911-913.
|
[11]HALBERT C, ALTIERI MS, YANG J, et al.Long-term outcomes of patients with common bile duct injury following laparoscopic cholecystectomy[J].Surg Endosc, 2016, 30 (10) :4294-4299.
|
[12]ASHFAQ A, AHMADIEH K, SHAH AA, et al.The difficult gall bladder:outcomes following laparoscopic cholecystectomy and the need for open conversion[J].Am J Surg, 2016, 212 (6) :1261-1264.
|
[13]PAN W, FANG JM, WANG Q.Causes and treatment of bile leakage after laparoscopic cholecystectomy (LC) [J].J Hepatobiliary Surg, 2016, 24 (3) :208-210. (in Chinese) 潘文, 方金满, 王青.腹腔镜胆囊切除 (LC) 术后胆漏原因及治疗[J].肝胆外科杂志, 2016, 24 (3) :208-210.
|