腹腔镜胆囊切除术后不放置引流管治疗急性化脓性胆囊炎的效果及影响

The eff ect and impact of placing drainage tubes after laparoscopic cholecystectomy for the treatment of acute suppurative cholecystitis

目的 探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)后放置引流管与不放置引流管治疗急性化脓性胆囊炎的效果及影响。方法 选取2022年1月至2023年9月北京市通州区中医医院收治的86例急性化脓性胆囊炎患者,均接受腹腔镜下胆囊切除术治疗,按照术后置管与否分组,A组43例患者术后不放置引流管,B组43例患者术后放置引流管,比较两组围手术期指标、炎症指标及术后并发症发生情况。结果 A组患者术后肛门排气时间、下床活动时间、住院时间均短于B组,差异有显著性(P<0.05)。两组患者术前C反应蛋白、白细胞计数、白介素-6水平无明显差异(P> 0.05);术后3d,A组患者上述指标水平均优于B组,差异有显著性(P <0.05)。A组患者术后切口疼痛、感染、胆漏、肩部疼痛等发生率显著低于B组(P <0.05)。结论 急性化脓性胆囊炎患者采用腹腔镜胆囊切除术后不放置引流管,能缩短患者术后恢复时间,降低并发症发生风险。

Objective To explore the eff ect of placing drainage tubes or not after laparoscopic cholecystectomy(LC)on the treatment of acute suppurative cholecystitis and its impact on traumatic inflammatory response.Method 86 patients with acute suppurative cholecystitis admitted between January 2022 and September 2023 were all treated with LC.They were divided into groups based on whether to place a drainage tube after surgery.Group A had 43 patients who did not place a drainage tube after surgery,while Group B had 43 patients who placed a drainage tube after surgery.The perioperative indicators,infl ammatory indicators,and postoperative complications between two groups were compared.Result The postoperative anal exhaust time,mobilization time,and hospitalization time of Group A patients were shorter than those of Group B,with signifi cant diff erences(P<0.05).There was no signifi cant diff erence in preoperative C-reactive protein,white blood cell count,and interleukin-6 levels between the two groups of patients(P>0.05);3 days after surgery,the levels of the above indicators in Group A were better than those in Group B,with signifi cant diff erences(P<0.05).The incidence of postoperative incision pain,infection,bile leakage,and shoulder pain in Group A patients was signifi cantly lower than that in Group B(P<0.05).Conclusion Patients with acute suppurative cholecystitis who undergo LC without placement of drainage tubes can shorten their postoperative recovery time and reduce the risk of complications.