高龄急性化脓坏疽性胆囊炎患者行腹腔镜手术与开腹手术的对比分析

Comparative analysis between laparoscopic surgery and laparotomy in the treatment of elderly patients with acute purulent and gangrenous cholecystitis

目的:对比分析腹腔镜手术与开腹手术治疗高龄急性化脓坏疽性胆囊炎患者的优越性。方法:回顾分析115例急性化脓坏疽性胆囊炎高龄患者的临床资料。其中60例行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC组),55例行开腹胆囊切除术(open cholecystectomy,OC组),对比分析两组患者术中与术后等情况。结果:115例手术均获成功。两组手术时间、术中出血量、住院时间及术后恢复情况差异有统计学意义(P<0.05)。结论:腹腔镜胆囊切除术治疗高龄急性化脓坏疽性胆囊炎具有手术时间短、术中出血少、术后肠道功能恢复快、痛苦轻及住院时间短等优点,临床经验丰富、腹腔镜技术掌握熟练的术者首选腹腔镜手术治疗。

Objective：To compare the superiority between laparoscopic surgery and laparotomy in the treatment of elderly pa- tients with acute purulent and gangrenous eholecystitis. Methods ：The clinical data about 115 elderly patients with acute purulent and gangrenous cholecystitis were retrospectively analyzed. They were divided into LC group （60 cases） and OC group （55 cases）. And in- traoperative and postoperative situations of the two groups were compared. Results：All the 115 patients were operated successfully. The difference between LC group and OC group about operation time, hospital stay, amount of intraoperative bleeding and postoperative re- covery was statistically significant （P 〈 0.05）. Conclusions：Laparoscopic surgery in tile treatment of elderly patients with acute puru- lent and gangrenous cholecystitis has such advantages as faster surgery,less blood loss, faster recovery of postoperative bowel function, less pain and shorter hospital stay than laparotomy. For the surgeons with experienced clinical and laparoscopic technique, laparoscopic operation is the first choice.