The Clinical Curative Effect of Laparoscopic Cholecystectomy in Treatment of 1353 Patients with Acute Calculous Cholecystitis in Acute Stage / 昆明医科大学学报

ABSTRACT

Objective To explore the clinical curative effect of laparoscopic cholecystectomy (LC) in treatment of patients with acute calculouscholecystitis in acute stage. Methods We retrospectively analysed the data of 1353 patients with acute calculouscholecystitis in acute stage who received laparoscopic cholecystectomy in Dept.of General Surgery, The First Affiliated Hospital of Nanyang Medical College and Dept.of Hepatopancreatobiliary Surgery 3,The 2nd Affiliated Hospital of Kunming Medical University from August 2008 to December 2012. Results In 1353 patients, 1316 patients were performed LC successfully (97.27%) . One patient was found with bile duct injury and was cured after Laparoscopic T tube drainage. Two patients were found with postoperative bile leakage, one of them was found with wing hole effusion after removal of the abdominal cavity drainage tube, and was cured after continuous drainage. The operation time was 26-168 minutes, with an average of 47 minutes, the hospitalization time was 3-15 days, with an average of 7.3 days. No incision infection was found . 37 patients were transferred to laparotomy because of common bile duct injury in 2 cases, unclear gallbladder triangle in 23 cases, difficult operation after decompression result from high gall bladder pressure caused by big calculus incarceration in the gallbladder neck in 3 cases, gallbladder gallstone disease in 2 cases, atrophic and vitrified acute cholecystitis and biliary calculus in 2 cases, gallbladder artery bleeding in 4 cases and severe abdominal cavity adhesion in 1 case. Conclusion For patients with acute calculous cholecystitis in acute stage, LC is asafe, effective, and minimally invasive treatment method with quick recovery and low cost, but the operator must be familiar with the anatomy of Calot triangle,and has skilled LC operation skills.