Application of Laparoscopic Cholecystectomy in the Therapy of Cholelithiasis Associated with Liver Cirrhosis_West China Medical Journal

Authors：

1 Department of General Surgery, Chengdu Railway Central Hospital, Chengdu Sichuan 610081 China; 2 Department of General Surgery, Chengdu 10th People’s Hospital, Chengdu Sichuan 610061;

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Keywords：

肝硬化; 胆囊结石; 胆囊切除术,腹腔镜

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目的:探讨腹腔镜胆囊切除术对胆囊结石合并肝硬化的围手术期影响及技术特点。方法:回顾分析80例胆囊结石合并肝硬化患者行腹腔镜胆囊切除术(LC)、开腹胆囊切除术(OC)前后肝功能、凝血功能及术中出血量、手术时间、术后住院时间、术后禁食时间等临床资料并比较两组间差异。结果:全组无死亡、术后肝功能衰竭、胆道损伤、胆漏等严重并发症病例。手术及麻醉对肝功能、凝血功能的影响在LC、OC两组间比较差异无显著意义(P gt;0.05)。LC组在手术时间、术中出血量、术后禁食时间、术后住院时间等指标方面优于OC组,两组间差异有显著意义(P lt;0.05)。结论:与OC比较,胆囊结石合并肝硬化行LC是安全的,并且有着微创、术后恢复快等优势,关键是掌握手术的技术特点、注重Child-push分级及围手术期的处理。

Citation： YUAN Jiatian,WEI Guo,WEN Xianmin,et al.. Application of Laparoscopic Cholecystectomy in the Therapy of Cholelithiasis Associated with Liver Cirrhosis. West China Medical Journal, 2009, 24(7): 1649-1651. doi: Copy

1.	魏国,何敏,范合璋等.肝炎后肝硬化合并胆囊结石的临床分析[J].中国实用医药杂志,2006,1(4):41-42.
2.	POGGIO J L, Acomparison of laparoscopic and open cholecystectomy in patients with compensated cirrhosis and symptomatic gallstone disease[J].Surgery, 2000,127:405-411.
3.	URBAN L, EASON G A, REMINE S, et al．Laparoscopic cholecystectomy in patients with early cirhosis[J]．Cur Surg,2001,58(3):312-315.
4.	中华医学会肝病学分会、传染病与寄生虫病学分会修订.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8(6):324.
5.	BOMMAN P C, TERBLANCHE J. Subtotal cholecystectomy: For the dificult gallbladder in portal hypertension and cholecystitis[J]．Surgery,1985,98(1):1-6.
6.	嵇武,李令堂,汪志明,等. 肝硬化门静脉高压患者腹腔镜与胆囊切除术的随机对照研究[J]．中华消化内镜杂志,2004,21(5):337-339.
7.	HALERY A, GOLDDENTCH R, NEYRI M, et al．Are elevated liver enzymes and bilirubin levels significant after LC in the absence ofbile duct injury[J]．Ann Surgy,1994,219:362-364.
8.	周群,邓明,彭立勋等.腹腔镜胆囊切除术治疗胆囊结石合并肝硬化的临床对照观察[J]. 肝胆外科杂志,2000,8(1):58-59.
9.	陈新刚.肝硬化合并胆囊结石行腹腔镜与开腹胆囊切除手术疗效比较[J]. 中原医刊,2007,34(l4)58-59.

1. 魏国,何敏,范合璋等.肝炎后肝硬化合并胆囊结石的临床分析[J].中国实用医药杂志,2006,1(4):41-42.
2. POGGIO J L, Acomparison of laparoscopic and open cholecystectomy in patients with compensated cirrhosis and symptomatic gallstone disease[J].Surgery, 2000,127:405-411.
3. URBAN L, EASON G A, REMINE S, et al．Laparoscopic cholecystectomy in patients with early cirhosis[J]．Cur Surg,2001,58(3):312-315.
4. 中华医学会肝病学分会、传染病与寄生虫病学分会修订.病毒性肝炎防治方案[J].中华肝脏病杂志,2000,8(6):324.
5. BOMMAN P C, TERBLANCHE J. Subtotal cholecystectomy: For the dificult gallbladder in portal hypertension and cholecystitis[J]．Surgery,1985,98(1):1-6.
6. 嵇武,李令堂,汪志明,等. 肝硬化门静脉高压患者腹腔镜与胆囊切除术的随机对照研究[J]．中华消化内镜杂志,2004,21(5):337-339.
7. HALERY A, GOLDDENTCH R, NEYRI M, et al．Are elevated liver enzymes and bilirubin levels significant after LC in the absence ofbile duct injury[J]．Ann Surgy,1994,219:362-364.
8. 周群,邓明,彭立勋等.腹腔镜胆囊切除术治疗胆囊结石合并肝硬化的临床对照观察[J]. 肝胆外科杂志,2000,8(1):58-59.
9. 陈新刚.肝硬化合并胆囊结石行腹腔镜与开腹胆囊切除手术疗效比较[J]. 中原医刊,2007,34(l4)58-59.

West China Medical Journal

Application of Laparoscopic Cholecystectomy in the Therapy of Cholelithiasis Associated with Liver Cirrhosis

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