急性胆囊炎合并胆囊结石行腹腔镜胆囊切除术的困难因素分析  

Analysis of the difficult factors of laparoscopic cholecystectomy for acute cholecystitis with gallbladder stone

作　　者：张烨[1] 孙加林[1] 窦慧强[1] 张科明[1] 周雄[1] ZHANG Ye SUN Jia-lin DOU Hui-qiang et al(Department of Laparoscopic Surgery, Wuxi People＇s Hospital, Wuxi 214023, China)

机构地区：[1]无锡市人民医院,江苏无锡214023

出　　处：《腹腔镜外科杂志》2017年第8期609-611,共3页Journal of Laparoscopic Surgery

摘　　要：目的:分析急性胆囊炎合并胆囊结石患者行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的困难因素,以提高手术安全性,减少术后并发症的发生。方法:随机选取219例急性胆囊炎合并胆囊结石行LC的患者,观察术前发作次数、伴随疾病、术前住院时间、手术时间、术后住院时间等指标。应用ANOVA单因素分析与多重线性回归分析统计结果。结果:胆囊大小、患者性别与手术操作难度相关,胆囊壁厚度、胆囊炎发作次数与手术时间、出血量、术后住院时间的关系较小,同时非上腹部大手术不会影响手术时间、出血量及术后住院时间。结论:胆囊大小、患者性别与手术操作难度存在一定联系,而胆囊壁厚度、胆囊炎发作次数可能并不是影响LC手术难度的主要因素,同时下腹部手术、上腹部微创手术都不会影响手术的操作难度。Objective： Laparoscopic cholecystectomy（ LC） has become the standard treatment for acute cholecystitis with cholecystolithiasis. This study aims to analyze the difficult factors of LC for acute cholecystitis with cholecystolithiasis in order to improve the safety of surgery and reduce the rate of postoperative complications. Methods： Two hundred and nineteen patients who underwent LC because of acute cholecystitis with gallbladder stones were randomly selected. The preoperative seizure frequency,concomitant disease,preoperative hospital stay,operative time,postoperative hospital stay and so on were observed. Single factor ANOVA and multiple linear regression analysis were used in statistical analysis. Results： The gallbladder size and the gender of patients were related to difficulty of the operation. The gallbladder wall thickness and cholecystitis attack frequency had no significant relationship with operative time,the amount of bleeding in operation and postoperative hospital stay. Non upper-abdominal operation had no effect on operative time,the amount of bleeding in operation and postoperative hospital stay. Conclusions： The size of gallbladder and the gender of patients have some relations with the difficulty of LC. The thickness of gallbladder wall and cholecystitis attack frequency may be not the main factors of difficulty of surgery,while lower abdominal surgery and upper abdominal minimally invasive surgery will not affect the operation difficulty.

关 键 词：胆囊炎 急性 胆囊结石病 胆囊切除术 腹腔镜 手术难度 因素分析 统计学 

分 类 号：R657.4[医药卫生—外科学]