腹腔镜胆囊切除术治疗胆囊结石伴急性胆囊炎手术时机及术中技巧探讨  

The Timing and Technique of Laparoscopic Cholecystectomy for the Treatment of Gallbladder Stones with Acute Cholecystitis

作　　者：何龙光[1] 陈钦寿[1] 李大生[1] 黎福良[1] 黄军伟[1] HE Longguang;CHEN Qinshou;LI Dasheng;LI Fuliang;HUANG Junwei(Department of Hepatobiliary Surgery,Gaozhou People's Hospital,Gaozhou,Guangdong Province,525232 China)

机构地区：[1]广东省高州市人民医院肝胆外科,广东高州525232

出　　处：《系统医学》2021年第11期114-116,共3页Systems Medicine

摘　　要：目的探讨腹腔镜胆囊切除术(LC)治疗胆囊结石伴急性胆囊炎手术时机及术中技巧。方法该次研究将2019年1月—2020年5月该院70例胆囊结石伴急性胆囊炎患者随机分为两组,一组为早期组35例,患者发病72 h内接受腹腔镜胆囊切除术;另一组为择期组35例,患者发病72 h后接受腹腔镜胆囊切除术,比较两组手术指标、并发症发生率情况。结果对比两组并发症发生情况,早期组并发症发生率为(2.86%),择期组并发症发生率为(14.28%),早期组并发症发生率更低,但差异无统计学意义(χ^(2)=1.641,P>0.05);早期组术中出血量(32.54±15.02)mL、手术时间(42.54±19.32)min、术后排气时间(19.24±4.82)h、术后住院时间(4.94±2.42)d均优于择期组,两组比较差异有统计学意义(t=12.399、7.576、9.785、3.119,P<0.05)。结论患者发病72 h内行腹腔镜胆囊切除术,可明显缩短手术时间、住院时间、术后排气时间,并能减少术中出血量,疗效显著,值得临床应用。Objective To explore the timing and intraoperative techniques of laparoscopic cholecystectomy(LC)for the treatment of gallbladder stones with acute cholecystitis.Methods In the study,70 patients with cholecystolithiasis complicated with acute cholecystitis in the hospital from January 2019 to May 2020 were randomly divided into two groups.One group was the early group with 35 patients.The patients underwent laparoscopic cholecystectomy within 72 hours of onset.The other group consisted of 35 cases in the elective group.The patients underwent laparoscopic cholecystectomy 72 hours after the onset of onset.The surgical indicators and complication rates of the two groups were compared.Results The complication rate of the two groups was compared.The complication rate of the early group was 2.86%,the complication rate of the elective group was 14.28%,and the complication rate of the early group was lower,but the difference was not statistically significant(χ^(2)=1.641,P>0.05).In the early group,intraoperative blood loss(32.54±15.02)mL,operation time(42.54±19.32)min,postoperative exhaust time(19.24±4.82)h,postoperative hospital stay(4.94±2.42)d were all better than the elective group,and the difference between the two groups was statistically significant(t=12.399,7.576,9.785,3.119,P<0.05).Conclusion Laparoscopic cholecystectomy within 72 hours of onset of the patient can significantly shorten the operation time,hospital stay,and exhausting time,and can reduce intraoperative blood loss,the effect is remarkable,and it is worthy of clinical application.

关 键 词：腹腔镜胆囊切除术 胆囊结石 急性胆囊炎 手术时机 术中技巧 

分 类 号：R657[医药卫生—外科学]