老年急性结石性胆囊炎腹腔镜胆囊切除术手术时机的探讨

Efficacy and timing of laparoscopic cholecystectomy for acute cholecystitis

目的探讨急性结石性胆囊炎行腹腔镜胆囊切除术(LC)手术时机与疗效的关系。方法将我院收治的急性结石性胆囊炎老年患者分为早期手术组和延期手术组,观察两组手术治疗效果及患者康复情况。结果两组出血量及并发症发生率无差异(P>0.05)。早期组术中转开腹率、治疗费用及其他手术效果指标优于延期组(P<0.05)。早期组胃肠功能康复情况及预后指标均优于延期组(P<0.05)。结论急性结石性胆囊炎应尽早行LC术,以提高手术治疗效果,促进术后康复及降低治疗费用。

Objective To explore the relationship between operation time and the clinical efficacy in patients with acute calculous cholecystitis. Methods Sixty-seven cases of patients with acute calculous cholecystitis were divided into two groups according to the tim-ing of the surgery. The early group was treated with operation within 72h, while the delay group was treated with operation 72h later, then the effect of operation and prognosis of the two groups were observed. Results There was no significant difference between the two groups in the incidence of complications and the amount of bleeding (P>0. 05). The early group was significantly better than the delay group in the con-version rates to an open procedure, the total cost of treatment and other operation index(P<0. 05). The early group was significantly better than the delay group in the time of ambulation, flatus time, postoperative VAS score, the hospitalization time and the incidence of wound in-fection, and there was significant difference between the two groups (P<0. 05). Conclusion The timing for surgery in patients with acute calculous cholecystitis should be within the shortest interval after onset of symptoms no matter whether the interval is within 72h or not; the early operation has important clinical value in improving the clinical effect and the rehabilitation of patients.