胆囊结石并肝硬化患者行腹腔镜与开腹胆囊切除术的对比研究

Comparative study of laparoscopic cholecystectomy and open cholecystectomy for patients with cholelithiasis associated with cirrhosis

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗胆囊结石合并肝硬化患者的优点、可行性和疗效。方法:胆囊结石合并肝硬化患者72例,随机分成LC组39例和开腹胆囊切除术(open cholecystectomy,OC)组33例,同组按编号、年龄、性别、肝功能分级等收集和分析数据。结果:LC组和OC组平均手术时间分别为(56.0±4.1)min和(70.8±5.2)min(P<0.05),术中平均出血量分别为(97.7±4.03)ml和(133.9±8.64)ml(P<0.05),平均住院时间分别为(6.2±1.9)d和(9.11±2.3)d(P<0.05),手术并发症发生率分别为10.2%(4例)和27.3%(9例)(P<0.05)。结论:胆囊结石合并肝硬化的患者用LC治疗优势明显,与OC相比更加安全可靠。

Objective： To evaluate the the advantages, feasibility and benefits of laparoscopic cholecystectomy（LC） for patients with cholelithiasis associated with cirrhosis. Methods：Seventy two cases with symptomatic cholelithiasis and cirrhosis were randomly divided into LC group （39 cases） and open cholecystectomy （OC） group （33 cases）. The cohorts were well-matched for number, age, sex, child classification. Data of the two groups were collected and analyzed. Results ： LC group and the OC group were operative time （ 56.0 ± 4.1 ） min and （70.8 ± 5.2） min （ P 〈 0.05 ）, bleeding respectively （ 97.7 ± 4.03 ） ml and （ 133.9 ± 8.64 ） ml （ P 〈 0.05 ）, length of hospitalization, respectively （ 6.2 ± 1.9 ） d and （ 9.11 ± 2.3 ） d （ P 〈 0.05 ）, surgical complication rate was 10.2% （ 4 cases ） and 27.3% （9 cases） （P 〈 0.05 ）. Conclusions：Cholelithiasis with cirrhosis to use LC has obvious advantages compared to OC.