腹腔镜切除术治疗急性胆囊炎临床观察及中转原因分析  

Effect of laparoscopic cholecystectomy in treating acute cholecystitis and reason of conversion to open operation

作　　者：赵强[1] 姜世平[1] 张利勇[1] 

机构地区：[1]四川省雅安市人民医院普外科,四川雅安625000

出　　处：《医药论坛杂志》2013年第12期38-40,共3页Journal of Medical Forum

摘　　要：目的研究腹腔镜切除术治疗急性胆囊炎临床疗效及中转原因。方法选择急性胆囊炎患者作为研究对象,随机分为给予腹腔镜手术的观察组和开放手术的对照组,观察手术相关指标、中转开腹手术险因素。结果观察组手术时间、术中出血量、术后引流量、排气时间、下床时间分别为(118.62±11.13)min、(98.54±9.52)ml、(25.54±2.58)ml、(1.52±0.23)d、(3.05±0.41)d,明显少于对照组(P<0.05);中转开放者的上腹部病手术史例数、急性胆囊炎发作例数、白细胞计数、胆囊壁厚度均大于未中转开放者,与中转开放手术呈正相关。结论上腹部手术史、急性胆囊炎发作、白细胞计数偏高以及胆囊壁厚度增加均是中转进行开放手术的危险因素,在临床中应谨慎选择腹腔镜手术。Objective To study the effect of laparoscopic cholecystectomy in treating acute cholecystitis and reason of conversion to open operation. Methods Acute eholecystitis patients were collected and divided into observation group given laparoscopic operation and control group given open operation. Then operation related index and risk factors of con version to open operation were observed. Results Operation time, intraoperative bleeding volume, postoperative drain age, exhaust time, bedding time of observation group were（ 118.62 ± 11.13）min, （98. 54 ±9.52） ml, （25.54 ±2. 58） ml, （ 1.52 ± 0. 23 ） d, （ 3.05 ± 0. 41 ） d , significantly less than the control group ; cases of abdominal operation history and acute eholecystitis, WBC and gallbladder wall thickness of patient converting to open operation were more than those without gallbladder wall thickness and had positive correlation with conversion to open operation. Conclusion Laparo seopic operation should be careful selected for patients with history of abdominal operation, acute cholecystitis, WBC and thickness of gallbladder wall.

关 键 词：急性胆囊炎 腹腔镜 胆囊切除术 开放手术 

分 类 号：R657.4[医药卫生—外科学]