腹腔镜胆囊切除术前肠道清洁的比较研究

Comparative study of no preoperative bowel preparation before laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术前不行肠道清洁准备的可行性。方法选择腹腔镜胆囊切除术患者80例，随机分为观察组42例与对照组38例。对照组术前常规服用50％硫酸镁50ml和温开水1000ml，观察组，术前不行肠道准备。比较两组患者术中肠胀气情况、手术时间、术后肠功能恢复时间、术后24h恶心呕吐的发生率。结果80例患者均安全接受手术，术中未发生结肠负损伤或因肠胀气延误手术的情况；两组患者平均手术时间、术后肠功能恢复时间和术后24h恶心呕吐的发生率差异均无统计学意义。结论腹腔镜胆囊切除术前不行肠道清洁准备是可行的，且可避免饮用导泻药及大量饮水导致的腹胀、恶心呕吐等不良反应。

Objective To evaluate the necessity of preoperative bowel preparation prior to laparoscopic cholecystectomy. Methods A prospective study was performed from Jan to Sep in 2008 in general hospital of Chinese PLA. Eighty patients who accepted selective LC were randomly assigned to control group in which preoperative bowel preparation was introduced prior to LC and experiment group in which the patients received conventional preoperative procedure without bowel preparation prior to LC. The clinical date was recorded and compared in respect of exposure of operation field, operative time, recovery time of bowel movement and postoperative morbidity. Results The operation was uneventful in all patients. No statistical difference existed between the two groups in operative time and recovery time of bowel movement. The incidence of postoperative nausea and vomiting was similar in both groups. No major operative morbidity including colorectal and duodenal injuries was found in all patients. Conclusions Preoperative bowel preparation before LC is dispensable. Conventional preoperative procedure without bowel preparation does not increase operative risk and minimizes the patient＇ s discomfort during the clinical pathway of laparoscopic surgery.