Laparoscopic converted to open surgery for acute cholecystitis Analysis of 22 cases.docVIP

 PAGE \* MERGEFORMAT 7 Laparoscopic converted to open surgery for acute cholecystitis Analysis of 22 cases [Keywords:] Laparoscopy laparotomy for acute cholecystitis Our department from October 2002 to October 2009, on 370 patients with acute cholecystitis were treated by laparoscopic surgery, laparotomy, 22 cases of acute cholecystitis is laparoscopic laparotomy the reasons for the following analysis. 1 Materials and Methods 1.1 The group of 370 cases of clinical data, 163 cases of male and female 207 cases, aged 30 to 73 years, average 49.7 years old. Have different levels of right upper quadrant pain with nausea and vomiting, had fever,gt; 38 , 128 cases have different degrees of right upper quadrant tenderness, rebound tenderness and muscle tension, Murphy sign was positive. ultrasonography were prompted increased gallbladder, gallbladder wall thickness of 3 ~ 6 mm, 248 cases of gallbladder stones inside, no stones in 122 cases; gallbladder effusion around 65 cases, 5 cases of gangrenous cholecystitis; no expansion of the common bile duct and found no stones. leukocytes 13 109 ~ 21 109 / L, with varying degrees of abnormal liver function of 98 cases. onset 12 ~ 72 h The average 28 h. 1.2 Treatment of all cases using general anesthesia, CO2 pneumoperitoneum, the pressure in the 10 ~ 14 mmHg. Are used four-hole method, free adhesions, gallbladder decompression first, bring the gallbladder, cystic duct and common bile duct observed to determine the junction site, at the junction more sites of the cystic duct and cystic artery free, under the right costal margin and the anterior axillary line crossing jack indwelling gallbladder bed drainage. 24 h after the beginning into the liquid diet, no abnormal circumstances, within 48 h after removal of the gallbladder bed drainage tube All cases admitted to hospital after antibiotics, the body temperature returned to normal after drug withdrawal. 2 Results All patients were hospitalized within 48