腹腔镜治疗早期急性胆囊炎与慢性胆囊炎的疗效比较

Comparison on the Efficacy of Laparoscopic Treatment between Cholecystitis and Chronic Cholecystitis in Early Stage

目的比较早期急性胆囊炎与慢性胆囊炎的腹腔镜治疗区别及疗效。方法回顾性分析2018年1月至2019年2月北京市房山区第一医院收治的62例胆囊炎患者的临床资料,依据发病急性程度分为早期急性胆囊炎组34例及慢性胆囊炎组28例,所有患者均采用腹腔镜胆囊切除手术治疗,对比两组患者手术时间、住院时间、首次排气时间、肠道蠕动恢复时间、中转开腹率。结果早期急性胆囊炎组,1例因存在广泛黏连,无法显露而转为开腹;慢性胆囊炎组,2例因胆囊解剖结构异常而转为开腹,两组患者中转开腹率比较,差异无统计学意义(P>0.05)。慢性胆囊炎组手术时间短于早期急性胆囊炎组,术中出血量高于早期急性胆囊炎组,两组比较差异有统计学意义(P<0.05)。两组住院时间、首次排气时间、肠道蠕动恢复时间比较,差异无统计学意义(P>0.05),两组患者均无并发症发生。结论腹腔镜治疗早期急性胆囊炎与慢性胆囊炎,在住院时间及术后胃肠道恢复方面的效果相当,但是治疗早期急性胆囊炎效果更佳,手术时间短,安全有效。

Objective To compare the efficacy of laparoscopy treatment between early acute cholecystitis and chronic cholecystitis.Methods The clinical data of 62 cases of cholecystitis were analyzed retrospectively from January 2018 to February 2019 in Fangshan District First Hospital of Beijing.According to the degree of acute onset,34 patients were divided into early acute cholecystitis group and 28 patients into chronic cholecystitis group.All patients were treated by laparoscopic cholecystectomy.The operation time,hospital stay,first exhaust time,recovery time of intestinal peristalsis,and conversion rate of the two groups were compared.Results Among the patients with early acute cholecystitis,1 patient was converted to open operation because of extensive adhesion,which could not be revealed;among the patients with chronic cholecystitis,2 patients were converted to open operation because of abnormal gallbladder anatomy.There was no significant difference in the conversion rate between the two groups(P>0.05).The operation time of the chronic cholecystitis group was shorter than that of the early acute cholecystitis group,and the intraoperative bleeding volume was higher than that of the early acute cholecystitis group,the difference between the two groups was statistically significant(P<0.05).There were no significant differences in hospital stay,first exhaust time and recovery time of intestinal peristalsis between the two groups(P>0.05),and no complications occurred in both groups.Conclusion Laparoscopic cholecystitis in early acute cholecystitis and chronic cholecystitis,in the length of hospital stay and postoperative gastrointestinal recovery,but the treatment of early acute cholecystitis is better,the operation time is short,safe and effective。