在我国开展门诊腹腔镜胆囊切除术的可行性研究  

The feasibility of out-patient laparoscopic cholecystectomy in China

作　　者：嵇武[1] 李令堂[1] 王永光[2] 丁凯[1] 陈兴东[2] 林宁[2] 李宁[1] 黎介寿[1] 

机构地区：[1]南京军区南京总医院解放军普通外科研究所,江苏南京210002 [2]南京军区南京总医院麻醉科,江苏南京210002

出　　处：《医学研究生学报》2008年第7期734-737,共4页Journal of Medical Postgraduates

基　　金：南京军区医学科学技术研究“十一五”计划课题基金资助项目(批准号:06MA112)

摘　　要：目的:报道门诊腹腔镜胆囊切除术(OPLC)的初步经验,探讨OPLC的可行性、适应证范围、操作流程和优势。方法:对60例OPLC患者的临床资料进行回顾性分析。结果:OPLC手术成功率为100%,手术时间为(22.5±11.0)min,术中出血量为(16.5±6.5)ml。患者术后恢复进流质时间为(10.5±2.0)h,恢复进半流饮食时间为(21.0±4.0)h,术后平均留院观察时间为(31.0±6.5)h。除4例在术后第2 d回家外,其余56例均在术后第1 d回家。OPLC的平均总费用明显低于同期住院腹腔镜胆囊切除术(LC)。术后2周随访,评价非常满意15例,满意41例,不满意4例,总体满意率为93.3%。结论:OPLC可在门诊安全地进行。该术可显著缩短患者的手术等待时间,有效地提高医院的床位周转率,大大减少患者住院的不适感,并在一定程度上降低治疗费用。但目前在我国开展OPLC尚有许多需要解决的问题。Objective： This study was designed to explore the feasibility, indications, clinical pathway and benefits of out-patient laparoscopic cholecystectomy （OPLC） and to evaluate this new method. Methods ： Perioperative data of the first consecutive 60 cases of OPLC in our institute were collected and retrospectively analyzed. Results： The success rate of OPLC is 100%. The median operation time was （22.5 ±11.0）min. The estimated operative blood loss was （16.5 ±6.5）ml. The time to resume liquid food was （10.5 ± 2.0）h. The time to resume semi-liquid food was （21.0±4.0）h. Mean postoperative hospital observation time was （31.0 ± 6.5 ） h. Fifty-six patients left hospital in the first day after operation, another 4 patients in the second day after the operation. Compared with normal in-hospital laparoscopic cholecystectomy （LC）, the cost of OPLC decreased significantly. All patients were followed at 2 weeks after OPLC. The results were very satisfactory in 15 cases, satisfactory in 41 cases, not satisfactory in 4 cases. The total rate of satisfaction was 93.3%. Conclusion： OPLC is feasible and safe. It can shorten the operation waiting time for patients, increase bed turnover in the hospital, decrease uncomfortable feeling of patients and the cost of LC. But there are still many problems for the widespread use of OPLC in our country, now.

关 键 词：腹腔镜胆囊切除术 门诊手术 治疗费用 可行性 

分 类 号：R657.4[医药卫生—外科学]