腹腔镜下左侧入路胆囊切除术在急性胆囊炎患者中的应用  

Clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis

作　　者：齐敦峰 张昕辉[1] 李欢送[1] 石奎[1] 袁博[1] 刘养岁[1] 

机构地区：[1]徐州市中心医院肝胆外科,江苏徐州221009

出　　处：《中国普外基础与临床杂志》2017年第12期1492-1495,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨腹腔镜下左侧入路胆囊切除术在急性胆囊炎患者中应用的安全性及疗效。方法回顾性收集2015年1月至2017年5月期间于笔者所在医院住院且接受手术治疗的急性胆囊炎患者120例,按所施行的手术方式分为对照组和观察组,每组60例。对照组患者入院后急诊行常规腹腔镜胆囊切除术,观察组患者入院后急诊行腹腔镜下左侧入路胆囊切除术。比较2组患者的术中情况、术后恢复情况和并发症发生情况。结果观察组的手术时间、术后肛门首次排气时间、术后住院时间、白细胞恢复至正常时间和凝血功能恢复至正常时间均明显短于对照组(P<0.05),术中出血量也明显少于对照组(P<0.05),总并发症发生率明显低于对照组(P<0.05)。结论本研究的初步研究结果提示,腹腔镜下左侧入路胆囊切除术能明显改善急性胆囊炎患者的术中情况,促进患者恢复,降低术后并发症发生率,安全可靠。Objective To investigate clinical efficacy of laparoscopic cholecystectomy via left side approach for patients with acute cholecystitis. Methods One hundred and twenty patients with acute cholecystitis from January 2015 to May 2017 were collected. All of the patients were divided into observation group and control group according to the operative mode, with 60 cases in each group. In the observation group, the patients were treated by laparoscopic cholecystectomy via left side approach using the ligation-free technique to the main trunk of the cystic artery; in the control group, the patients were treated by the conventional laparoscopic cholecystectomy. After treatment, the operative situation, postoperative recovery, and incidence of postoperative complications were compared between these two groups. Results Compared with the control group, the operative time, first anal exhaust time, hospitalization stay, leukocytes recovery time, and coagulation function recovery time were shortened and the intraoperative bloods loss was reduced in the observation group, the differences were statistically significant （P〈0.05）. Furthermore, the overall postoperative complication incidence rate of the observation group was significantly lower than that of the control group （P〈0.05）. Conclusion For patients with acute cholecystitis, laparoscopic cholecystectomy via left side approach using ligation-free technique to main trunk of cystic artery is reliable and safe, which can effectively improve operative situation, shorten operative time, promote recovery of patient, and reduce incidence of postoperative complications.

关 键 词：急性胆囊炎 左侧入路 腹腔镜胆囊切除术 

分 类 号：R657.41[医药卫生—外科学]