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 mL；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。
Analysis of laparoscopic therapy for severe acute cholangitis in 117 cases
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 mL. 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.