急性胆囊炎腹腔镜胆囊切除术的手术时机再探讨

Further Discussion of the Timing of Laparoscopic Cholecystectomy for Acute Cholecystitis

目的探讨急性胆囊炎行腹腔镜胆囊切除术的可行性及手术时机的选择。方法回顾分析本院99例急性胆囊炎患者早期(72 h内,早期组)与晚期(抗炎2周内,晚期组)腹腔镜胆囊切除术的手术时间、住院时间、中转开腹率的关系。结果早期组29例中无中转开腹病例,平均手术时间72.4 min,平均住院5.2 d;晚期组70例中2例中转开腹,平均手术时间75.2 min,平均住院12.1 d。2组中转开腹率及手术时间比较无统计学差异,平均住院时间比较有显著统计学差异(P<0.01)。结论急性胆囊炎行腹腔镜胆囊切除术安全可行,72 h内手术可缩短住院时间且不增加手术难度及中转率。

Objective To explore the feasibility and the operation timimg of laparoscopic cholecystectomy for acute cholecystitis. Methods Ninty cases of laparoscopic cholecystectomy for acute cholecystitis were analyze and then correlation between operation time, total hospitalization days, conversion rates, postoperative complications of the early laparoscopic cholecystectomy （within 72 hours） and the late ones （within 2 weeks） were discussed. Results Twenty-nine cases were operated within 72 hours, and the average operation time was 72.4 minutes and the hospitalization days were 5.2, no conversion case were found. Seventy cases were operated within 2 weeks, and the average operation time was 75. 2 minutes and the average hospitalization days were 12.1. Two cases were converted to opening operation. There was no significant difference of operation time and conversion rates between two groups, but there was significant difference of hospitalization days between two groups（P〈0.01）. Conclusion Laparoscopic cholecystectomy for acute cholecystitis is feasible and safe,and the optimal operation time was within 72 hours of which there were no increasing conversion rates and operation difficulty, and the hospitalization days can be shorten.