腹腔镜下急性胆囊炎手术时机的选择

Laparoscopic surgery timing of acute cholecystitis

目的探讨急性胆囊炎行腹腔镜胆囊切除术的手术时机,并总结减少术后并发症的关键因素。方法回顾性分析2005年1月至2009年6月123例腹腔镜胆囊切除术治疗急性胆囊炎的临床资料。按手术时患者的发病时间分为三组:早期手术组(<72h)46例,晚期手术组(72h～1周)54例,择期手术组(4～6周)23例。结果对比3组并发症的发生率、手术中转率及住院时间,晚期手术组缩短了住院时间,节省了医疗费用。结论急性胆囊炎行腹腔镜胆囊切除术安全可行,且在抗炎治疗72h～1周内手术较为理想。

Objective To investigate the timing of laparoscopic cholecystectomy and summarize the critical factors of abating the postoperative complications. Methods One hundred and twenty three cases of laparoscopic cholecystectomy for acute cholecystitis were analyzed, which were randomly divided into three groups according to the disease time：early stage group（ 〈 72 h）, advanced stage group（72 h - lw）and selective operation group （ 4 - 6w）. The amount of the three groups were respectively 46,54 and 23. Results After analyzing the postoperative complication rate, conversion rate and hospitalization days of three groups, the advanced stage group had the least hospitalization days. Conclusion Laparoscopic cholecystectomy is a safe and feasible method for acute choleeystitics. It is a moderate time to perform laparoscopie cholecystectomy when the disease time is between 72 hours and 1 week.