两种手术方法治疗老年人胆囊结石的疗效比较

Curative effect comparison of two operation methods for treatment of elderly gallstones

目的对比腹腔镜胆囊切除术和开腹胆囊切除术治疗老年人胆囊结石的安全性和可行性。方法分别采用腹腔镜胆囊切除术和开腹胆囊切除术治疗胆囊结石患者145例,比较2组手术成功率及术中出血量、手术时间、术后镇痛情况、肛门排气时间、住院时间和并发症情况。结果 2组患者均顺利完成手术,完整取出胆囊,术中未发生意外,无死亡病例;术中取石1~5枚,最大直径2.5 cm。2组手术成功率均100%。2组术中出血量、手术时间、肛门排气时间、止痛药物应用率、住院时间、术后并发症发生率比较有显著性差异（P〈0.05）。结论采用腹腔镜胆囊切除术治疗胆囊结石比开腹胆囊切除术更安全、方便,且具有切口小、创伤少、术中出血少、伤口疼痛轻、住院时间短、并发症少、对机体影响小、术后康复快等优点。

Objective It is to compare the safety and feasibility of laparoscopic cholecystectomy and open cholecystectomy treatment on elderly gallstones.Methods 145 elderly patients with gallstone were treated by laparoscopic cholecystectomy and open cholecystectomy apartly.The success rate of operation,amout of bleeding,operation time,postoperative pain,anal exhaust time,hospital stay and complications in both groups were compared.Results All operations were completed successfully,stones were completely removed from the gall bladders,and there was no accident and no deaths in the surgery.There were 1 to 5 stones with the maximum diameter of 2.5 cm.The surgical success rates were as high as 100% in both groups.The amout of bleeding,operation time,anal exhaust time,application rate of analgesic drugs,hospital stay and the incidence of postoperative complications were significant difference between two groups（P0.05）.Conclusion Compared with the open cholecystectomy,the treatment of gallstones during laparoscopic cholecystectomy is safer,more convenient,and has a smaller incision,less trauma,less bleeding,less wound pain,shorter hospital stay,fewer complications,less impact on the body,sooner rehabilitation and so on.