免气腹腹腔镜胆囊切除术的临床分析

Clinical Analysis of Gasless Laparoscopic Cholecystectomy

目的探讨免气腹腹腔镜胆囊切除术的临床应用价值。方法回顾性分析临湘市人民医院2008年1月至2011年1月75例腹腔镜胆囊切除术患者的临床资料,其中免气腹腹腔镜手术35例,气腹腹腔镜手术40例,分析患者术前术中术后的临床情况。结果所有患者均顺利完成手术,气腹组的手术时间、术中出血量优于免气腹组,两组有显著性差异(P均<0.05),免气腹组肠道功能恢复时间、住院时间、并发症情况优于气腹组,两组有显著性差异(P均<0.05)。结论免气腹腹腔镜胆囊切除术扩大了腹腔镜胆囊切除术的范围,不失为一种操作简便,易于掌握的方法,尤其是对合并心肺功能不全、糖尿病等老年患者,有不可取代的作用,是值得基层医院临床推广的新技术。

Objective To investigate the clinical applications of gasless laparoscopic cholecystectomy.Methods Clinical datas of 75 cases of laparoscopic cholecystectomy including 35 cases of free pneumoperitoneum laparoscopic surgery and 40 cases of pneumoperitoneum laparoscopic surgery from January 2008 to January 2011 were collected in the People＇s Hospital of Linxiang.The clinical situations of preoperative and postoperative were retrospectively analyzed.Results All patients were successfully operated and in operative time,blood loss,pneumoperitoneum group were better than free pneumoperitoneum group.There was significant difference between the two groups（P〈0.05）.Free pneumoperitoneum group in intestinal function recovery time,hospital stay,complications were better than pneumoperitoneum group and there was significant difference between the two groups（P〈0.05）.Conclusion Gasless laparoscopic cholecystectomy expanded the scope of laparoscopic cholecystectomy.After all,it was a method of simple and had an irreplaceable role especially with cardiopulmonary dysfunction,diabetes,elderly patients.The new technology would be worth to spread in clinical primary hospital.