腹腔镜胆囊切除术治疗急性胆囊炎712例分析

Analysis of Laparoscopic Cholecystecomy on 712 Cases of Acute Calculous Cholecystitis

目的 探讨腹腔镜胆囊切除术 (LC)治疗急性胆囊炎的疗效和手术操作技巧。方法 对比分析两组手术时间、术后住院时间、中转开腹手术率及并发症发生率。结果 单纯组和急性组手术时间分别为 2 9.93± 16 .89min和 4 0 .2 7± 31.6 3min(P <0 .0 1) ;术后住院时间分别为 3.76± 1.0 9d和 3.85± 1.35d(P >0 .0 5 ) ;中转开腹手术率分别为 0 .34%和 4 .0 7% (P <0 .0 1) ;并发症发生率分别为 0 .2 2 %和 1.83% (P <0 .0 1)。单纯组 99%以上的患者、急性组 95 %以上的患者均能经LC治愈。结论 只要能正确评估手术操作难度、选用技术娴熟的腹腔镜外科医师进行手术 ,便能显著降低中转开腹手术率及并发症发生率 。

Objective To investigate the therapeutic effect and the operative techniques of laparoscopic cholecystcetomy (LC) on acute calculous cholecystitis.Methods Operative time, postoperative hospital stay, the rate of conversion laparotomy and complication between the simple group and the acute group were compared.Results The operative time in the simple group and acute group was 29.93 ± 16.89 min and 40.27 ± 31.63 min ( P < 0.01 ).The postoperative hospitalization in the simple group and the acute group were 3.76 ± 1.09 days and 3.85 ± 1.35 days respectively ( P > 0.05 ). The rate of conversion laparotomy in the simple group and acute group was 0.34% and 4.07% respectively ( P < 0.01 ). The occurrence of complication was 0.22% and 1.83% respectively ( P < 0.01 ). Over 99% of the patients in the simple group were cured by LC and the curative rate in the acute group was 95%.Conclusions Provided we could set evaluation correctly on the operative difficulty and chose the skilled surgeons, the rate of conversion laparotomy and complication in the acute group could be reduced apparently and the same therapeutic effect also could be acquired as the simple group.