腹腔镜逆行次全胆囊切除术对慢性结石性胆囊炎的临床价值

Clinical value of laparoscopic retrograde subtotal cholecystectomy for chronic calculous cholecystitis

目的探讨腹腔镜逆行次全胆囊切除术对慢性结石性胆囊炎的临床价值。方法64例慢性结石性胆囊炎患者,按照随机数字表法分为对照组和观察组,每组32例。对照组实施标准化的腹腔镜逆行全胆囊切除术,观察组实施腹腔镜逆行次全胆囊切除术。对比两组患者治疗效果、手术相关指标。结果观察组治疗后总有效率为90.63%,对照组总有效率为68.75%,观察组总有效率明显高于对照组,差异具有统计学意义(P<0.05)。观察组手术时间(87.88±17.10)min明显短于对照组的(108.51±20.78)min,术中出血量(81.77±43.95)ml、所需补液量(846.21±168.31)ml均明显少于对照组的(115.66±52.22)、(963.28±146.59)ml,差异具有统计学意义(P<0.05)。两组术后第1天体温及术后引流时间、住院时间比较,差异无统计学意义(P>0.05)。结论慢性结石性胆囊炎患者基于腹腔镜引导下实施逆行次全胆囊切除术治疗,在治疗效果上较逆行全胆囊切除术的效果突出,且手术时间短,操作更为简单,临床应用价值突出。

Objective To discuss the clinical value of laparoscopic retrograde subtotal cholecystectomy for chronic calculous cholecystitis.Methods A total of 64 patients with chronic calculous cholecystitis were divided into control group and observation group according to random numerical table,with 32 cases in each group.The control group was treated with standardized laparoscopic retrograde cholecystectomy,and the observation group was treated with laparoscopic retrograde subtotal cholecystectomy.The therapeutic effect and surgical related indicators were compared between the two groups.Results The total effective rate of the observation group was 90.63%,which was 68.75% of the control group.The total effective rate of the observation group was obviously higher than that of the control group,and the difference was statistically significant(P<0.05).The surgery time(87.88±17.10)min of the observation group was obviously shorter than(108.51±20.78)min of the control group,intraoperative blood loss(81.77±43.95)ml and amount of fluid required(846.21±168.31)ml of the observation group were obviously less than(115.66±52.22)and(963.28±146.59)ml of the control group.All the difference was statistically significant(P<0.05).There was no statistically significant difference in body temperature on the 1st day after surgery,postoperative drainage time,hospitalization time between the two groups(P>0.05).Conclusion For patients with chronic calculous cholecystitis,laparoscopic retrograde subtotal cholecystectomy is more ideal than laparoscopic retrograde total cholecystectomy,and the surgery time is shorter,the operation is simpler,and the clinical application value is outstanding.