【摘要】 目的:探讨急诊腹腔镜治疗急性重症胆管炎的疗效及手术操作要点。方法:回顾性分析2007年1月—2014年11月期间为117例胆总管结石继发急性重症胆管炎行腹腔镜治疗患者的临床资料。结果:全组中110例(94.0%)完全在腹腔镜下完成胆总管切开取石手术,7例中转开腹;平均手术时间144 min,术中出血量53 m L;4例术后感染性休克加重,经抗休克治疗后治愈,术后十二指肠瘘1例,胆汁漏3例,腹腔积液感染4例,经引流及抗感染后治愈;平均住院时间为7.2 d。结论:在严格把握适应证及熟练掌握腹腔镜操作技术的条件下,腹腔镜治疗急性重症胆管炎是安全可行的。更多还原

【Abstract】 Objective: To investigate the efficacy and essential technical points of laparoscopic treatment for severe acute cholangitis(SAC).Methods: The clinical data of 117 patients with SAC secondary to common bile duct stones, who underwent laparoscopic treatment during January 2010 to November 2014, were retrospectively analyzed. Results: In the entire group, 110 patients(94.0%) underwent totally laparoscopic common bile duct exploration, and 7 patients required open conversion. The mean operative time was 144 min and intraoperative blood loss was 53 m L. The septic shock was exacerbated in 4 patients after operation, which improved by antishock measures, while postoperative duodenal fistula, bile leakage and intra-abdominal collection occurred in 1, 3 and 4 cases respectively, which were resolved by drainage and anti-infective treatment. The mean length of postoperative hospital stay was 7.2 d.Conclusion: Based on rigorous medical indications and proficient laparoscopic skill, laparoscopic therapy of SAC is safe and feasible.更多还原