目的：探讨“高危”胆囊结石的疾病特点，总结其行腹腔镜胆囊切除术的诊治经验。方法对我院自2008年10月至2012年3月收治的115例“高危”胆囊结石患者行腹腔镜胆囊切除术的临床资料进行回顾性分析。结果本组115例患者，其中胆囊充满性型结石并胆囊萎缩、瓷化47例，急性化脓性及坏疽性胆囊炎42例，胆囊颈部结石嵌顿20例，胆囊管结石3例，胆囊十二指肠瘘2例，Mirizzi综合征1例。其中急诊腹腔镜胆囊切除术51例，其余均行择期手术，均康复出院。结论“高危”胆囊结石患者，经积极术前准备，加强围手术期的处理，术中精准、规范及娴熟的手术操作，行腹腔镜胆囊切除术是可行的。%Objective To investigate the characteristics of high-risk cholecystolithiasis and summarize the experience of laparoscopic chol-ecystectomy for this disease.Methods A retrospective analysis was performed on the clinical data of 1 15 patients with high-risk cholecys-tolithiasis who underwent laparoscopic cholecystectomy in our hospital from October 2008 to March 2012.Results Of the 1 15 patients,47 had stones filling the gallbladder as well as atrophy of the gallbladder and porcelain gallbladder,42 had acute suppurative and gangrenous cholecystitis,20 had stone incarceration in the gallbladder neck,3 had cystic duct stones,2 had cholecystoduodenal fistula,and 1 had Mi-rizzi syndrome;all patients were cured and discharged.Conclusion For patients with high-risk cholecystolithiasis,laparoscopic cholecys-tectomy is feasible,given active preoperative preparation,strengthened perioperative management,and accurate,standard,and skilled sur-gical operation.
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