腹腔镜与开腹手术治疗急性胆囊颈部嵌顿结石的对比研究

Study on the Effect of Laparoscopic Cholecystectomy and Open Cholecystectomy Treating for Acute Calculi Incarcerated in Neck of Gallbladder

目的比较腹腔镜胆囊切除术（laparoscopic cholecystectomy,LC）与开腹胆囊切除术（Open cholecystectomy,OC）治疗急性胆囊颈部嵌顿结石的临床效果。方法选取2002年1月～2010年1月急性胆囊颈部嵌顿结石行手术治疗的患者102例,随机分为OC组60例,LC组42例。结果 OC组及LC组手术时间分别为（86.50±14.35）min和（100.50±22.08）min（P〉0.05）;术中出血量（82.70±17.95）ml和（49.00±13.17）ml（P〈0.05）;术后引流量（122.00±31.55）ml和（82.00±22.87）ml（P〈0.05）;住院时间（10.60±1.95）d和（7.00±1.24）d（P〈0.05）。结论随着手术熟练程度及手术技巧的提高,腹腔镜胆囊切除术治疗急性胆囊颈部嵌顿结石是切实可行的。而且LC与OC相比具有创伤小、出血少、恢复快、术后住院时间短以及腹壁创口小、瘢痕小等优点。

Objective To explore the clinical effects of the laparoscopic cholecystectomy and open cholecystectomy.Methods From January 2002 to January 2010,102 patients with acute calculi incarcerated in neck of gallbladder were chosen,of which LC group was 42 patients and OC group was 60 patients.Results compared between OC group and LC group,the mean operative time was respectively（86.50±14.35）min and（100.50±22.08）min（P0.05）;the quantity of blood lost during operation was respectively（82.70±17.95）ml and（49.00±13.17）ml（P0.05）;postoperative drainage was respectively（122.00±31.55）ml and（82.00±22.87）ml（P0.05）;postoperative hospitalization was respectively（10.60±1.95）d and（7.00±1.24）d（P0.05）.Conclusion with the surgical proficiency and improvement of surgical technique,LC is safe,effective and feasible.Compared with OC,LC has the advantages of mild injury,less bleeding,rapid recovery and short postoperative hospitalization and minimal scar.