腹腔镜胆囊切除术治疗胆囊结石伴急性胆囊炎手术时机及术中技巧探讨

Laparoscopic cholecystectomy for cholecystolithiasis with acute cholecystitis

目的探讨腹腔镜胆囊切除术治疗胆囊结石伴急性胆囊炎手术时机及术中技巧。方法选取2019年1月至2020年5月于高州市人民医院接受治疗的胆囊结石伴急性胆囊炎患者70例,随机分为两组,一组为早期组35例,患者发病72h内接受腹腔镜胆囊切除术;另一组为择期组35例,患者发病72h后接受腹腔镜胆囊切除术,比较两组手术指标、并发症发生率等情况。结果对比两组并发症发生情况,早期组并发症发生率为2.86%,择期组并发症发生率为14.28%,差异无显著性(P>0.05)。对比两组手术指标,涉及手术、术后排气、术后住院等时间以及术中出血量,早期组各项指标较佳,差异有显著性(P<0.05)。结论在胆囊结石伴急性胆囊炎患者行腹腔镜胆囊切除术时,最佳治疗时间为患者发病72h内,一旦超过这一时间会增加手术难度。

Objective To explore the operative timing and intraoperative skills of laparoscopic cholecystectomy for cholecystolithiasis with acute cholecystitis.Methods From January 2019 to may 2020,70 cases of gallstone with acute cholecystitis were randomly divided into two groups,one group was early group,35 cases were treated with laparoscopic cholecystectomy within 72 hours after onset of disease;the other group was 35 cases of selective group,patients received laparoscopic cholecystectomy after 72 hours of onset,the operation indexes and complication rate of the two groups were compared.Results Compared with the incidence of complications in the two groups,the incidence of complications in the early group was 2.86%,and that in the selective group was 14.28%.The difference was not statistically significant(P>0.05).Compared with the operation indexes of the two groups,including operation,postoperative exhaust,postoperative hospital stay and intraoperative blood loss,the indicators of the early group were better(P<0.05).Conclusion In patients with cholecystolithiasis and acute cholecystitis undergoing laparoscopic cholecystectomy,the best treatment time is within 72 hours after the onset of the disease.Once this time is exceeded,it will increase the difficulty of operation.