胆囊穿刺引流后腹腔镜胆囊切除术治疗老年急性胆囊炎分析  

Analysis of laparoscopic cholecystectomy after percutaneous transhepatic gallbladder puncture and drainage for elderly patients with acute cholecystitis

作　　者：蔡军[1] 李子煜[1] 赵正阳 刘学停[1] 郑多安 孙艳军[1] 孙登群[1] CAI Jun;LI Ziyu;ZHAO Zhengyang(Department of General Surgery,Anhui Provincial General Hospital of Armed Police,Hefei 230041,China)

机构地区：[1]武警安徽省总队医院普通外科,安徽合肥230041

出　　处：《腹腔镜外科杂志》2023年第12期916-919,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨经皮经肝胆囊穿刺引流后择期行腹腔镜胆囊切除术治疗老年急性胆囊炎的方法及临床价值。方法:回顾分析2018年10月至2022年10月收治的70例老年急性胆囊炎患者的临床资料,并分为观察组与对照组,每组35例。观察组先行经皮经肝胆囊穿刺引流,待病情稳定后择期行腹腔镜胆囊切除术。对照组急诊行腹腔镜胆囊切除术。对比分析两组术中、术后相关指标及并发症发生率。结果:两组术后胆漏、中转开腹例数差异无统计学意义(P>0.05)。观察组手术时间、术中出血量、肠道功能恢复时间、术后腹腔引流时间、术后住院时间短于对照组,差异有统计学意义(P<0.05)。结论:经皮经肝胆囊穿刺置管引流后择期行腹腔镜胆囊切除术治疗老年急性胆囊炎安全、有效,患者康复快,创伤小,符合现代外科的损伤控制理念。Objective:To explore the method and clinical value of selective laparoscopic cholecystectomy after percutaneous transhepatic gallbladder puncture and drainage for elderly patients with acute cholecystitis.Methods:A retrospective analysis of 70 elderly patients with acute cholecystitis from Oct.2018 to Oct.2022 was conducted.All patients were divided into observation group(n=35)and control group(n=35).All patients of observation group performed percutaneous transhepatic gallbladder puncture drainage and selective laparoscopic cholecystectomy after the condition stabilized.Laparoscopic cholecystectomy were performed in the control group.The intraoperative and postoperative indicators and the incidence of complications were compared between the two groups.R esults:There was no significant difference in postoperative bile leakage and conversion to laparotomy between the two groups(P>0.05).The operation time,intraoperative blood loss,recovery of intestinal function,postoperative abdominal drainage time and postoperative hospital stay in the observation group were significantly lower than those in the control group(P<0.05).Conclusions:Selective laparoscopic cholecystectomy after percutaneous transhepatic gallbladder puncture and catheter drainage for elderly patients with acute cholecystitis is safe and effective,has minimal trauma to patients who recover quickly,and is in line with the concept of injury control in modern surgery.

关 键 词：胆囊炎 急性 胆囊切除术 腹腔镜 经皮经肝胆囊穿刺引流 老年人 

分 类 号：R657.41[医药卫生—外科学]