腹腔镜胆囊切除日间手术30例临床分析

Day surgery of laparoscopic cholecystectomy: a clinical analysis of 30 cases

目的:探讨日间手术模式在腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)中的安全性及可行性。方法:2014年4月28日至2014年7月20日拟行日间LC 30例,其中胆囊结石16例,胆囊息肉11例,胆囊结石合并胆囊息肉2例,慢性胆囊炎1例。患者术前于门诊行术前检查并进行准入评估。术后当日密切观察患者各项生命体征并进行出院评估。术后5 d内每天均对患者进行电话随访,了解并记录患者身体状况。结果:30例拟行日间手术的患者中,3例经术前检查未达日间手术准入标准转入常规住院治疗,余27例均顺利完成日间LC,其中26例于24 h内出院,术后无并发症或仅有轻微不适,1例术后体温达38.5℃,未达日间手术出院标准留院观察3 d后出院。结论:日间LC安全、可行,可降低医疗费用,适合在我国大型医院开展。

Objective：To investigate the safety and feasibility of laparoscopic cholecystectomy under the day surgery mode. Methods ： From Apr. 2014 to Jul. 2014,30 cases were scheduled for laparoscopie cholecysteetomy under the day surgery mode, including 16 cases of gallstone, 11 cases of gallbladder polypus ,2 cases of gallstone incorporated with gallbladder polypus and 1 chronic cholecys- tiffs. The patients underwent preoperative examination in outpatient and assessment evaluation. On the day after surgery, various vital signs of the patients were closely observed meanwhile the discharge assessments were carried out. Daily telephone follow-up was made for 5 days after surgery to understand and document the physical condition of the patients. Results：In the 30 day surgery patients, 3 ca- ses failed to meet day surgery preoperative access standards and were converted to conventional hospitalization, and the remaining 27 cases were successfully carried out laparoscopic cholecystectomy day surgery. 26 patients were discharged within 24 h, no postoperative complications or only mild discomforts were found. One patient＇ s body temperature reached 38.5℃, failed to meet day surgery discharge standards, was discharged after 3 d hospitalized observation. Conclusions：Laparoscopic cholecystectomy day surgery is safe and feasible, reduces expenses and increases hospital efficiency, and it is suitable for large hospitals in China.