急性结石性胆囊炎早期及延期腹腔镜胆囊切除的临床分析

Clinical analysis of early and delayed laparoscopic cholecystectomy for acute calculous cholecystitis

目的探讨急性结石性胆囊炎早期及延期腹腔镜胆囊切除的效果。方法 92例急性结石性胆囊炎患者,均行腹腔镜胆囊切除术治疗,根据发病至手术时间分为早期组(<72 h,54例)与延期组(72 h^1周,38例)。对比两组手术情况及预后情况。结果早期组手术用时短于延期组,胆汁渗出率、中转开腹率低于延期组,差异有统计学意义(P<0.05),两组术中失血量比较差异无统计学意义(P>0.05)。早期组下床时间、肛门排气时间、术后住院时间均短于延期组,差异有统计学意义(P<0.05),早期组并发症发生率为20.37%,延期组为10.53%,比较差异无统计学意义(P>0.05)。结论腹腔镜胆囊切除术为治疗急性结石性胆囊炎的有效方法 ,早期手术有利于提高手术成功率,患者术后恢复较快。

Objective To discuss the effect of early and delayed laparoscopic cholecystectomy for acute calculous cholecystitis. Methods A total of 92 patients with acute calculous cholecystitis all received laparoscopic cholecystectomy, and they were divided by time of onset to operation into early group（72 h, 54 cases） and delayed group（72 h ~1 weeks, 38 cases）. Comparison were made on surgical situation and prognosis between two groups. Results Early group had shorter operation time than delayed group, and lower bile exudation rate and conversion rate than delayed group. Their difference was statistically significant（P〈0.05）. Both groups had no statistically significant difference in intraoperative bleeding volume（P〉0.05）. Early group had shorter off-bed time, anus exhaust time and postoperative hospitalization time than delayed group, and their difference was statistically significant（P〈0.05）. The early group had incidence of complications as 20.37%, which was 10.53% in delayed group, and the difference was statistically significant（P〉0.05）. Conclusion Laparoscopic cholecystectomy is an effective method for the treatment of acute calculous cholecystitis, and early operation is helpful to improve the success rate of the operation, and the patients recover quickly after the operation.