腹腔镜胆囊切除术与开腹胆囊切除术治疗老年急性胆囊炎的疗效分析

Analysis of Curative Effect of Laparoscopic Cholecystectomy and Open Cholecystectomy in the Treatment of Elderly Patients with Acute Cholecystitis

目的对腹腔镜胆囊切除术与开腹胆囊切除术治疗老年急性胆囊炎的疗效进行对比分析。方法方便选择2015年3月—2017年3月期间在该院诊治的76例老年急性胆囊炎患者。根据患者病情选择开腹或者腹腔镜切除,其中急性胆囊炎早期,无严重并发症的患者选择腹腔镜胆囊切除术,共40例;胆囊严重感染、发炎或有巨型胆石患者选择开腹胆囊切除术,共36例。对患者手术中创伤情况、手术后身体恢复情况和手术并发症进行对比分析。结果腹腔镜组的患者手术时间和切口长度分别为(52.6±16.4)min和(2.5±0.5)cm,均短于开腹组,手术出血量为(58.4±13.2)m L也少于开腹组。两组手术相关数据相比较,差异有统计学意义(P<0.05)。手术后,做腹腔镜胆囊切除术的患者肠道恢复、拆线时间和住院时间分别为(3.1±0.8)d、(7.2±1.5)d和(8.2±1.6)d,也明显短于开腹组(P<0.05)。腹腔镜组患者切口感、腹腔感染、胆漏、术后黄疸并发症总人数共有4例,几率为10.0%,开腹组共13例,几率为36.1%(P<0.05)。结论腹腔镜胆囊切除手术在治疗老年急性胆囊炎中,具有手术创伤小、术后恢复快、手术并发症少的优点,是一种安全高效的治疗方法,具有临床推广应用价值。

Objective This paper tries to compare and analyze the efficacy of laparoscopic cholecystectomy and open cholecystectomy in the treatment of elderly patients with acute cholecystitis. Methods 76 elderly patients with acute cholecystitis diagnosed and treated in this hospital from March 2015 to March 2017 were convenient selected and divided according to condition of patients. 40 cases of patients in the early stage of acute cholecystitis with no serious complications adopted laparoscopic cholecystectomy. Open cholecystectomy were performed in 36 cases of patients with severe gallbladder infection,inflammation or a large gallstone. The surgical trauma, the recovery of the body after operation and the complications of operation were compared and analyzed. Results The average operative time and incision length of the laparoscopic group were(52.6±16.4)min and 2.5±0.5)cm, shorter than those of the laparotomy group, and the amount of bleeding was(58.4±13.2)m L,which was less than that of the laparotomy group. The surgical data of the two groups were statistically significant(P<0.05).After operation, patients with laparoscopic cholecystectomy were significantly shorter than the laparotomy group(P<0.05) in intestinal recovery of(3.1±0.8)d, suture removal time of(7.2±1.5)d and hospitalization time of(8.2±1.6)d. The total number of incisional wound, abdominal infection, bile leakage and postoperative complications of the laparoscopic group was 4 cases,accounting for 10.0%, and that of the laparotomy group was 13 cases, accounting for 36.1%(P <0.05). Conclusion Laparoscopic cholecystectomy in the treatment of acute cholecystitis in the elderly has the advantage of small surgical trauma,faster postoperative recovery, fewer complications, and it is a safe and effective treatment method, it has the value of clinical application and promotion.