腹腔镜与小切口手术切除胆囊治疗胆结石比较

Comparison of laparoscopic cholecystectomy and mini-incision cholecystectomy in treating gallstone

目的：对比观察腹腔镜与小切口手术切除胆囊治疗胆结石的临床疗效。方法：胆结石患者112例随机分为两组,腹腔镜胆囊切除术（LC）组60例,采用气管插部管全身麻醉,镜下探查胆囊、胆囊三角、胆总管解剖及炎性反应、粘连程度,电凝钩分离胆囊,胆囊床电凝止血,剑突下穿刺孔取出胆囊。小切口胆囊切除术（MC）组52例,采用硬膜外麻醉,B超定位胆囊底、胆囊颈部的位置,切口长约4~6 cm,常规进入腹腔后切除。结果：两组切口长度、术中出血量、住院时间及住院费用比较差异均有统计学意义（P〈0.05）,手术时间差异并无统计学意义（P〉0.05）;LC组并发症发生率15%明显低于MC组34.6%（2χ=5.86,P〈0.05）。结论：LC和MC治疗胆结石均是理想术式,可根据情况选用。

Objective： To compare the effect of laparoscopic cholecystectomy（LC） and mini-incision cholecystectomy（MC） on gallstone.Methods： A total of 112 patients with gallstone were randomly divided into two groups,LC group（60 cases） and MC group（52 cases）.Patients in LC group had general anesthesia via tracheal intubation.The anatomical status,inflammatory reaction status and adhension of gall bladder,Calot′s triangle and common bile duct were observes under laparoscopy.Gall bladder was separated by electronic coagulation hook,and electric coagulation hemostasis was carried out.The gall bladder was isolated from puncture site under xiphoid process.Patients in MC group had epidural anesthesia.With the location of fundus of gallbladder and neck of gallbladder by B-ultrasound.The gallbladder was excised with incision length as 4-6 cm.Results： There were significant differences in incision length,bleeding volume during surgery,hospitalization duration and cost between two groups（P0.05）,but no significant difference in surgery time（P0.05）.The incidence of complication was significantly lower in LC group（15% vs 34.6%）（χ2=5.86,P0.05）.Conclusions： LC and MC are satisfactory surgical option for gallstone.They can be used according to different status of patients..