腹腔镜胆囊切除术治疗复杂胆囊炎的临床观察

Clinical observation of laparoscopic cholecystectomy for the treatment of complex cholecystitis

目的探讨腹腔镜胆囊切除术治疗复杂胆囊炎的可行性和临床应用价值。方法回顾性总结分析滨州医学院附属即墨人民医院2020年3月至2023年3月收治的80例复杂胆囊炎患者的临床资料,根据手术方式的不同分为对照组和试验组,各40例。试验组患者采用腹腔镜胆囊切除术,对照组同期采用行经皮经肝胆囊穿刺置管引流后二期行腹腔镜胆囊切除术。比较两组患者在手术时间、术中出血量、术后胆漏、切口感染、胆管残余结石、胆(肠)管损伤、治疗效果、住院时长等方面的差异。结果两组患者均无围手术期死亡病例。试验组较对照组,手术时间较长,手术出血量较多,差异均有显著性(P<0.05)。两组患者术中中转开腹率、术中胆道损伤率、肠管损伤及术后住院时间、术后出血无显著差异(P>0.05)。结论复杂胆囊炎行腹腔镜下胆囊切除术可以缩短治疗周期。

Objective To explore the feasibility and clinical application value of laparoscopic cholecystectomy in the treatment of complex cholecystitis.Method A retrospective analysis was conducted on the clinical data of 80 patients with complex cholecystitis admitted to Jimo People's Hospital Affi liated to Binzhou Medical College from March 2020 to March 2023.According to diff erent surgical methods,they were divided into a control group and an experimental group,with 40 cases in each group.The experimental group patients underwent laparoscopic cholecystectomy,while the control group underwent percutaneous transhepatic gallbladder puncture and drainage followed by laparoscopic cholecystectomy in the second phase during the same period.Compare the diff erences between two groups of patients in terms of surgical time,intraoperative bleeding,postoperative bile leakage,incision infection,residual bile duct stones,bile(intestinal)duct injury,treatment effectiveness,and length of hospital stay.Result There were no perioperative deaths in either group of patients.The experimental group had a longer surgical time and more surgical bleeding compared to the control group,with signifi cant diff erences(P<0.05).There was no signifi cant diff erence in the conversion rate to open surgery,intraoperative biliary injury rate,intestinal injury,postoperative hospital stay,and postoperative bleeding between the two groups of patients(P>0.05).Conclusion Laparoscopic cholecystectomy for complex cholecystitis can shorten the treatment cycle.