腹腔镜与开腹胆囊切除术治疗急性胆囊炎的效果比较

Comparison of the Therapeutic Efficacy between Laparoscopic Cholecystectomy and Open Cholecystectomy for Patients with Acute Cholecystitis

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）治疗急性胆囊炎的效果.方法 回顾性比较行胆囊切除术治疗的急性胆囊炎患者114例,其中LC 53例,OC 61例,比较两种手术的手术时间、术中出血量、下床活动时间、术后排气时间、住院时间、住院综合费用、切口感染率和置引流管率的差异.结果 与OC组比较,LC组手术时间、下床活动时间和术后排气时间短,术中出血量少,住院时间短,住院费用低,切口感染率低,置引流管的比率低,差异均有统计学意义（P〈0.05）.两组患者中均无胆道损伤、胆漏病例.均获随访,平均时间13.3（2～48）个月,均未发现胆管损伤、胆漏损伤、胆囊残株炎、胆囊切除术后综合征等并发症. 结论与OC相比,LC治疗急性胆囊炎具有创伤小、并发症少和综合费用少等优点,是治疗急性胆囊炎可行的手术方式.

Objective To compare the therapeutic efficacy between laparoscopic cholecystectomy（LC） and open cholecystectomy（OC） for patients with acute cholecystitis.Methods 114 patients with acute cholecystitis from January 2006 to December 2009 were operated by cystectomy.Among them,53 cases received LC and 61 cases received OC.Result Comparing with the OC group,the LC group showed obvious adventures in the operative time,the intraoperative bleeding volume,the bed rest period,the recovery time of the gastrointestinal function,the average hospitalization duration after operation,the hospitalization charges,the rate of incisional infection and the using of the placement of drainage tube（P0.05）.Conclusion LC may be a feasible and safe therapy for the treatment of acute cholecystitis with many advantages such as mini-trauma,few complications,and relatively fewer hospital cost.