日间腹腔镜胆囊切除术的可行性分析  

Feasibility analysis of day-case laparoscopic cholecystectomy

作　　者：刘力玮 郑亚民[1] 刘东斌[1] 王悦华[1] 刘家峰[1] 梁阔[1] 江华[1] 高崇崇[1] 于志浩 徐大华[1] LIU Li-wei;ZHENG Ya-min;LIU Dong-bin(Department of General Surgery,Xuanwu Hospital of Capital Medical University,Beijing 100053,China;Department of Burn and Plastic Surgery,Miyun Teaching Hospital,Capital Medical University)

机构地区：[1]首都医科大学宣武医院普通外科,北京100053 [2]首都医科大学密云教学医院烧伤整形科

出　　处：《腹腔镜外科杂志》2021年第5期359-362,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨日间腹腔镜胆囊切除术(DCLC)的可行性。方法:回顾分析2018年1月1日至2019年12月31日施行腹腔镜胆囊切除术患者的临床资料,分为DCLC组与常规腹腔镜胆囊切除术(RLC)组。对比两组患者一般情况、手术安全性、卫生经济学指标。结果:共纳入1870例患者,其中DCLC组246例,RLC组1624例。计划DCLC患者中13例24 h后延迟出院,原因包括放置腹腔引流管(7.7%)、切口疼痛(15.4%)、进食后恶心呕吐(23.1%)及术后焦虑(53.8%);两组患者性别、病因、伴发疾病、腹部手术病史、手术时间、术中出血、术后并发症差异均无统计学意义(P>0.05)。DCLC组年龄、住院时间、住院费用低于RLC组(P<0.05),满意度评分高于RLC组(P<0.05)。行DCLC的两个手术组患者年龄、性别、病因、伴发疾病史、腹部手术史、手术时间、术中出血、住院时间、住院费用、满意度评分差异均无统计学意义(P>0.05)。结论:熟练掌握LC的术者均可安全施行DCLC,不会增加术后并发症的发生风险,并能显著缩短住院时间、降低住院费用、提升患者满意度。Objective:To investigate the feasibility of day-case laparoscopic cholecystectomy(DCLC).Methods:The clinical data of patients who underwent laparoscopic cholecystectomy from Jan.1,2018 to Dec.31,2019 were retrospectively analyzed.The patients were divided into DCLC group and routine laparoscopic cholecystectomy(RLC)group.The general situation,operative safety and health economic indicators of the two groups were compared.Results:A total of 1870 patients were enrolled,including 246 DCLC patients and 1624 RLC patients.13 patients of the planned DCLC patients were discharged after 24 h because of abdominal drainage(7.7%),incision pain(15.4%),nausea and vomiting after eating(23.1%)and postoperative anxiety(53.8%).There were no significant differences in gender,etiology,concomitant diseases,abdominal surgery history,operation time,intraoperative bleeding and postoperative complications between the two groups(P>0.05).The age,hospital stay and cost of hospitalization in DCLC group were lower than those in RLC group(P<0.05).The satisfaction score of DCLC group was higher than that of RLC group(P<0.05).There was no significant difference in age,gender,etiology,history of concomitant diseases,history of abdominal surgery,operation time,intraoperative bleeding,hospital stay,cost of hospitalization and satisfaction score between the two groups of DCLC(P>0.05).Conclusions:DCLC can be performed safely by the doctors skilled in laparoscopic cholecystectomy,it significantly reduces the hospital stay,hospitalization costs and improves patients’satisfaction without increased risk of postoperative complications.

关 键 词：日间手术 胆囊切除术 腹腔镜 可行性研究 

分 类 号：R657.4[医药卫生—外科学]