刍议腹腔镜与开腹手术治疗急性胆囊颈部嵌顿结石的对比

Comparison of the Effect Between Laparoscopic Surgery and Open Surgery on Acute Calculi Incarcerated in Neck of Gallbladder

目的对比腹腔镜与开腹手术治疗急性胆囊颈部嵌顿结石的临床疗效。方法整群抽取2013年4月—2015年2月该院接诊的120例急性胆囊颈部嵌顿结石患者作为研究对象,其中72例患者行腹腔镜手术治疗,设为LC组;另48例患者行开腹手术治疗,设为OC组。观察两组患者的手术时间、术中出血量、住院时间等指标,并比较两组术后的引流量。结果 LC组的手术时间稍高于OC组,然而术中出血量、住院时间以及肛门排气时间均明显优于OC组,组间比较差异有统计学意义(P<0.05);LC组患者术后3d的腹腔引流量均显著低于OC组,两组比较差异有统计学意义(P<0.05)。结论采用腹腔镜切除胆囊术较开腹手术对急性胆囊颈部嵌顿结石可以减少术中出血量,缩短患者的住院时间,可在临床推广使用。

Objective To compare the clinical efficacy between laparoscopic and open cholecystectomy in the treatment of acute calculi incarcerated in neck of gallbladder. Methods 120 cases with acute calculi incarcerated in neck of gallbladder admitted in our hospital from April 2013 to February 2015 were selected as the subjects. Of them, 72 cases underwent laparoscopic cholecystectomy were set as the LC group, and other 48 cases underwent open cholecystectomy were set as the OC group. The duration of operation, intraoperative blood loss and length of stay and other indicators of the two groups were observed. And the volume of postoperative abdominal drainage of the two groups was compared. Results Compared with the OC group, LC group had slightly longer duration of operation. The intraoperative blood loss, length of stay and anus exhaust time of the LC group were significantly less than those of the OC group with statistically significant difference(P<0.05). The volume of abdominal drainage 3d after surgery was much less in the LC group than that in the OC group with statistically significant difference(P <0.05). Conclusion For patients with acute calculi incarcerated in neck of gallbladder, compared with open surgery, laparoscopic cholecystectomy can reduce the intraoperative blood loss and shorten the length of stay, so it can be used and promoted in clinical practice.