腹腔镜胆囊切除术治疗急性胆囊炎的时机选择

The selection of the timing of laparoscopic cholecystectomy for acute cholecystitis

目的:探讨急性胆囊炎患者行腹腔镜胆囊切除术的时机选择。方法:选取2008-2011年因急性胆囊炎于我院行腹腔镜胆囊切除术的患者共130例,根据症状出现与手术的间隔时间分为3组,A组(发病3d内手术)36例、B组(发病4～7d手术)59例、C组(出现症状7d后手术)35例,对不同组别患者的并发症、住院时间、预后等进行记录并进行统计学分析。结果:3组间的并发症、住院时间、预后差异均无显著性。结论:腹腔镜胆囊切除术对首诊即为急性胆囊炎的患者是安全可靠的,手术效果与就诊时间无关。

Objective To investigate the selection of the timing of laparoscopic cholecytectomy for patients with acute cholecystitis. Methods Between 2008 and 2011, 130 patients with acute cholecystitis were treated with laparoscopic cholecytectomy. All the patients were divided into 3 groups according to the timing of the surgery： Group A （n = 36）, within the first 3 days, Group B（n = 59）, between 4-7 days, and Group C （n = 35）, beyond 7 days after the onset of symptoms. The conversion rate, morbidity and postoperative hospital stay were recorded and analyzed. Results There was no significant difference in the conversion rate, morbidity and postoperative hospital stay among the 3 groups. Conclusion Laparoscopic cholecystectomy for acute cholecystitis during the index admission is safe, regardless of the time elapsed from the onset of symptoms.