腹腔镜胆囊次全切除术治疗急性结石性胆囊炎合并肝硬化的疗效分析

Analysis of laparoscopic subtotal cholecystectomy in cirrhosis with acute calculous cholecystitis

目的探讨腹腔镜胆囊次全切除术治疗急性结石性胆囊炎合并肝硬化的可行性及临床疗效。方法2019年1月~2021年12月我院行腹腔镜手术治疗的急性结石性胆囊炎合并肝硬化病人92例,其中48例行腹腔镜胆囊次全切除术为LSTC组(研究组),44例行腹腔镜胆囊完全切除术为LC组(对照组)。分析并对比手术时间、术中出血量、术后腹腔引流管拔除时间、术后住院时间、住院费用及术后并发症。结果腹腔镜胆囊次全切除术组的手术时间为(32.13±17.52)分钟、术中出血量为(92.52±35.67)ml,腹腔镜胆囊全切除术组的手术时间为(49.11±23.26)分钟、术中出血量为(159.18±45.26)ml,其手术时间、术中出血量比较,差异有统计学意义(P<0.05),两组术后腹腔引流管拔除时间、术后并发症发生率、术后住院时间、住院费用比较,差异无统计学意义(P>0.05)。结论腹腔镜胆囊次全切除术安全可行,其手术时间短、出血少、并发症少、术后恢复快,是急性结石性胆囊炎合并肝硬化(Child A、B级)病人可行的一个治疗选择。

Objective To explore the feasibility and clinical efficacy of laparoscopic subtotal cholecystectomy for cirrhosis combined with acute calculous cholecystitis.Methods Ninety-two cases of liver cirrhosis with acute calculous cholecystitis who were hospitalized in the Hospital of Ningxia Hui Autonomous Region from January 2019 to December 2021 were retrospectively analyzed.Fourty-eight patients underwent laparoscopic subtotal cholecystectomy(study group)and fourty-four patients underwent laparoscopic cholecystectomy(control group).The operative time,intraoperative blood loss,postoperative abdominal drainage tube removal time,postoperative hospital stay,hospitalization cost and postoperative complications were compared and analyzed between the two groups.Results In the laparoscopic subtotal cholecystectomy group,the operative time was(32.13±17.52)min and intraoperative blood loss was(92.52±35.67)ml,while in the laparoscopic total cholecystectomy group,the operative time was(49.11±23.26)min and intraoperative blood loss was(159.18±45.26)ml.The operative time and intraoperative blood loss were significantly different(P<0.05),while there were no significant differences in postoperative abdominal drainage tube removal time,postoperative length of hospital stay and hospitalization cost between the two groups(P>0.05).Conclusion Laparoscopic subtotal cholecystectomy is A safe and feasible treatment option for patients with liver cirrhosis(Child A,B)complicated with acute calculous cholecystitis due to its short operation time,less bleeding,fewer complications and faster postoperative recovery.