不同手术时机腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果比较

Effect comparison of laparoscopic cholecystectomy for the treatment of acute calculous cholecystitis at different operation timing

目的探究不同手术时机腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果。方法回顾性分析我院2016年2月~2017年2月应用腹腔镜切除术治疗的82例急性结石性胆囊炎患者资料,将其按照不同的手术时机分为A组(44例,在发病72 h予以腹腔镜胆囊切除术治疗)、B组(38例,在发病超过72 h内予以腹腔镜胆囊切除术治疗),分析治疗结果。结果 A组术后排气时间、平均住院时间均短于B组,差异有统计学意义(P<0.05)。A组患者的并发症发生率均低于B组,差异有统计学意义(P<0.05)。A组患者的中转开腹率[2.27%(1/44)]低于B组[15.79%(6/38)],差异有统计学意义(χ2=4.771,P=0.029<0.05)。结论急性结石性胆囊炎患者在发病72 h内予以腹腔镜胆囊切除术治疗,并发症少,安全性高,可促进患者术后恢复,降低中转开腹率。

Objective To explore the results of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis at different operation times.Methods The data of 82 patients with acute calculous cholecystitis undergone laparoscopic resection in our hospital from February 2016 to February 2017 were retrospectively analyzed.They were grouped according to different surgical timings.In group A（n=44）,the surgery was performed within 72 hours after onset,while in group B（n=38）,the laparoscopic cholecystectomy was performed over 72 hours after onset.The therapeutic effect was analyzed.Results The postoperative exhaust time and average hospitalization time in group A were shorter than those in group B,the differences were statistically significant（P〈 0.05）.The complication rates of patients in group A were lower than those in group B,and the difference was statistically significant（P〈0.05）.The conversion rate to laparotomy of patients in group A was（2.27%[1/44]） lower than that in group B（15.79%[6/38]）,and the difference was statistically significant（χ^2=4.771,P=0.029〈0.05）.Conclusion For patients with acute calculous cholecystitis,performace of laparoscopic cholecystectomy within 72 hours of onset has advantages of few complications,high safety,promotion of postoperative recovery,and decrease of conversion to laparotomy rate.