胆囊后三角解剖入路腹腔镜切除术治疗胆囊结石伴慢性胆囊炎的效果

The Effect of Laparoscopic Resection of Gallbladder Triangular Anatomical Approach in the Treatment of Cholecystolithiasis with Chronic Cholecystitis

目的分析予以胆囊结石伴慢性胆囊炎患者胆囊后三角解剖入路腹腔镜切除术治疗的临床效果。方法方便选择2018年6月—2021年10月在该院接受治疗的胆囊结石伴慢性胆囊炎患者46例为研究对象,采取随机数表法分为两组,两组均实施腹腔镜胆囊切除术治疗,其中经胆囊前三角入路的20例纳入对照组,经胆囊后三角解剖入路的26例纳入观察组,对比两组的临床效果。结果观察组术中出血量以及手术、排气、住院时间分别为(29.19±4.55)mL、(26.20±3.44)min、(17.20±3.60)h、(5.26±1.02)d,均低于对照组的(41.76±5.41)mL、(36.92±3.48)min、(29.70±4.52)h、(7.57±1.21)d,差异有统计学意义(t=8.556、10.425、10.446、7.022,P<0.05)。治疗后,观察组IL-6、IL-8、TNF-α水平分别为(19.05±1.34)、(13.48±2.25)、(17.33±4.25)ng/L,均低于对照组的(23.52±1.66)、(19.51±3.42)、(22.56±3.41)ng/L,差异有统计学意义(t=10.109、7.201、4.498,P<0.05)。观察组NO、5-HT水平均低于对照组,差异有统计学意义(t=9.729、5.278,P<0.05),且观察组并发症发生率(3.85%)低于对照组(30.00%),差异有统计学意义(χ^(2)=4.138,P<0.05)。结论予以胆囊结石伴慢性胆囊炎患者胆囊后三角解剖入路腹腔镜切除术治疗效果显著,并发症较少。

Objective To analyze the clinical effect of laparoscopic resection of the gallbladder in patients with cholecystolithiasis and chronic cholecystitis.Methods A total of 46 patients with cholecystolithiasis and chronic cholecystitis who were treated in the hospital from June 2018 to October 2021 were conveniently selected as the research subjects and were divided into two groups by random number table method.Both groups were treated with laparoscopic cholecystectomy,of which 20 cases through the anterior triangular approach of the gallbladder were included in the control group,and 26 cases through the anatomical approach through the posterior triangle of the gallbladder were included in the observation group,and the clinical effects of the two groups were compared.Results The intraoperative blood loss,operation,exhaust,and hospital stay in the observation group were(29.19±4.55)mL,(26.20±3.44)min,(17.20±3.60)h,and(5.26±1.02)d,respectively,which were lower than those in the control group(41.76±5.41)mL,(36.92±3.48)min,(29.70±4.52)h,(7.57±1.21)d,the difference was statistically significant(t=8.556,10.425,10.446,7.022,P<0.05).After treatment,the levels of IL-6,IL-8 and TNF-αin the observation group were(19.05±1.34)ng/L,(13.48±2.25)ng/L,(17.33±4.25)ng/L,which were lower than those in the control group(23.52±1.66)ng/L,(19.51±3.42)ng/L,(22.56±3.41)ng/L,the difference was statistically significant(t=10.109,7.201,4.498,P<0.05).The levels of NO and 5-HT in the observation group were lower than those in the control group,the difference was statistically significant(t=9.729,5.278,P<0.05),and the incidence of complications in the observation group(3.85%)was lower than that in the control group(30.00%),the difference was statistically significant(χ^(2)=4.138,P<0.05).Conclusion Laparoscopic resection of gallbladder with posterior triangle anatomical approach in patients with cholecystolithiasis and chronic cholecystitis is effective and has fewer complications.