腹腔镜胆囊切除治疗急性胆囊炎的临床探讨

Clinical analysis of laparoscopic cholecystectomy for acute cholecystitis

目的 探讨腹腔镜胆囊切除术（laparoscopic cholecystectomy，LC）治疗急性胆囊炎的可行性。方法 对2003年7月-2005年5月施行LC的229例急性胆囊炎病例（A组）进行回顾分析，并随机选择同期进行的非急性胆囊炎LC病例245例（B组）进行对照。结果 A组中转开腹9例，中转率3．93％，B组中转开腹4例，中转率1．63%，两组差异有统计学意义（P〈0．01）；平均手术时间：A组（59．3±12．6）min，B组（32．4±5．7）min，两组差异有统计学意义（P〈0．01）；术后胃肠功能恢复时间：A组（25．8±4．6）h，B组（25．1±3．7）h，两组差异无统计学意义（P〉0．05）；术后平均住院天数：A组（3．35±0．91）d，B组（3．17±0．89）d，两组相似（P〉0．05）。两组均无术中及术后并发症。结论 急性胆囊炎行LC是安全可行的，认真辨清胆囊三角区关系是LC成功的关键。

Objective To investigate the probability of laparoscopic cholecystectomy for acute cholecystitis. Methods Laparoscopic cholecystectomy performed in 229 patients with acute cholecystitls（group A） and 245 patients without acute cholecystitis（group B） from July 2003 to May 2005 were retrospectively analysed. Results Nine cases were changed to laparotomy （3.93%） in group A,and four cases to laparotomy （1. 63%） in group B （P〈0.01）. The average time for operation were 59.3 min ± 12.6 min in group A and 32.4 min ± 5.7 min in group B （P〈0.01）. The comeback time for gastrointestinal function was 25.8 h ±4.6 h in group A and 25.1 h ±3.7 h in group B （P〉0.05）. The average hospitalization time after operation was 3.35 d ±0.91 d in group A and 3.17 d± 0. 89 d in group B （P〉 0. 05）. All patients recovered without any complication. Conclusion Laparoscoplc cholecystectomy is a safe and effective method for acute cholecystltis. Corrective recognition of Calot＇s triangle may be the key factor to achieve successful operation.