胆囊结石伴急性胆囊炎行急诊腹腔镜胆囊切除术的疗效及手术安全性分析  

Analysis of the Efficacy and Safety of Emergency Laparoscopic Cholecystectomy for Gallstone with Acute Cholecystitis

作　　者：孙亭立[1] SUN Tingli(Jiujiang NO.1 People’s Hospital,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院,江西九江332000

出　　处：《中国医学创新》2020年第29期46-49,共4页Medical Innovation of China

摘　　要：目的:探讨胆囊结石伴急性胆囊炎行急诊腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗的效果及安全性。方法:选取本院2017年6月-2019年6月行LC治疗的64例胆囊结石伴急性胆囊炎患者为研究对象,将发病72 h内行急诊LC治疗的患者设为观察组(n=33),将发病72 h后行LC治疗的患者设为对照组(n=31)。观察两组的手术结局,对比两组手术相关指标、术后并发症发生情况、住院时间及住院费用。结果:观察组33例患者中32例成功行LC,1例中转开腹;对照组31例患者中26例成功行LC,5例中转开腹。观察组手术时间、肛门首次排气时间均显著短于对照组,术中出血量少于对照组(P<0.05)。观察组并发症发生率为21.21%,显著低于对照组的48.39%(P<0.05)。观察组住院时间、住院费用均显著少于对照组(P<0.05)。结论:对于胆囊结石伴急性胆囊炎患者且无腹腔镜手术禁忌的患者尽早行LC手术治疗,可缩短手术时间,减少术中出血量和术后并发症发生率,降低患者的住院费用。Objective:To investigate the efficacy and safety of laparoscopic cholecystectomy(LC)in the treatment of gallbladder stones with acute cholecystitis.Method:A total of 64 patients with gallbladder stones and acute cholecystitis who received LC treatment in our hospital from June 2017 to June 2019 were selected as the research objects.The patients who were treated by emergency LC within 72 h of onset were set as the observation group(n=33),those receiving LC treatment 72 h after onset were set as the control group(n=31).The surgical outcomes of the two groups were observed,and the operative indicators,postoperative complications,length of stay and hospitalization expenses were compared between the two groups.Result:In the observation group,32 cases were successfully performed LC,1 case was converted to laparotomy;in the control group,26 cases were successfully performed LC and 5 cases were converted to laparotomy.The operation time and the first anal exhaust time of the observation group were significantly shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).The incidence of complications in the observation group was 21.21%,significantly lower than 48.39%of the control group(P<0.05).The length of stay and hospitalization expenses of the observation group were significantly less than those of the control group(P<0.05).Conclusion:For patients with cholecystolithiasis and acute cholecystitis and without laparoscopic surgical contralies,LC surgery as early as possible is beneficial to shorten the operation time,reduce intraoperative blood loss and postoperative complications,and reduce the hospitalization costs of patients.

关 键 词：胆囊结石 急性胆囊炎 腹腔镜胆囊切除术 

分 类 号：R657.4[医药卫生—外科学]