急性结石性胆囊炎腔镜胆囊切除手术时机的选择

The choice of surgery opportunity of laparoscopic cholecystectomy in the treatment of acute calculous cholecystitis

目的:分析急性结石性胆囊炎行腔镜切除手术时机的选择。方法:2012年5月-2014年5月收治行腔镜切除的急性结石性胆囊炎患者60例,根据治疗方法与手术时间分为延期手术组与急诊手术组,各30例。对比两组住院时间、排气时间、引流管放置时间、并发症、中转开腹率以及手术时间。结果:在手术时间、引流管放置时间、排气时间以及住院时间方面,急诊手术组明显优于延期手术组,差异有统计学意义(P<0.05)。急诊手术中,中转开腹1例(3.33%),发生并发症2例(6.67%);延期手术组中,中转开腹4例(13.33%),发生并发症5例(16.67%),急诊手术组明显低于延期手术组,差异有统计学意义(P<0.05)。结论:对急性结石性胆囊炎患者采取急诊腔镜胆囊切除术是可行的,对患者造成创伤小,明显缩短住院时间,术后并发症减少,是治疗的首选方法,具有临床应用价值。

Objective:To analyze the acute calculous cholecystitis laparoscopic cholecystectomy surgery opportunity choice.Methods:60 patients with acute calculous cholecystitis laparoscopic cholecystectomy were selected from May 2012 to May 2014.According to the treatment method and the operation time,they were divided into the delayed operation group and emergency operation group with 30 cases in each.The hospitalization times,evacuation times,drainage tube placement times,complications,the transfer open rate and operation times of two groups were compared.Results:In the operation time,drainage tube placement time,evacuation time and hospitalization time,the emergency operation group was better than the delayed operation group,and the difference was statistically significant(P<0.05).In emergency operation,1 case(3.33%) was converted to laparotomy;2cases(6.67%) had complications.In the delayed operation group,4 cases(13.33%) were converted to laparotomy;5 cases(16.67%)had complications.The emergency operation group was significantly lower than the delayed operation group,and the difference was statistically significant(P<0.05).Conclusion:Emergency laparoscopic cholecystectomy is feasible in patients with acute calculous cholecystitis.It has small trauma for patients,shorten the hospitalization time,and reduced the postoperative complications.It is the preferred method of treatment.It has the clinical application value.