急性结石性胆囊炎选择腹腔镜手术时机的探讨

摘要

目的:探讨急性结石性胆囊炎患者行腹腔镜胆囊切除术(LC)的手术时机.方法:回顾性分析129例急性结石性胆囊炎患者的临床资料,所有患者均行手术治疗,设置观察组62例为实施手术距发病时间≤72h的患者,对照组67例为实施手术距发病时间＞72h的患者.结果:(1)观察组与对照组的LC手术成功率、手术时间和术中失血量比较有统计学意义(P＜0.05),两组术后的腹腔引流量、并发症发生率和平均住院时间均无统计学意义(P＞0.05).(2)观察组中成功行LC患者的手术时间和术中失血量均优于对照组中完成LC的患者(P＜0.05).结论:在急性结石性胆囊炎患者的炎症急性期应尽早进行手术治疗,LC可作为首选的手术方法,炎症后期LC手术难度明显增加,手术成功率下降.%Objective: To explore operation opportunity of laparoscopic cholecystectomy(LC) for patients with acute gallstone cholecystitis. Methods: The clinical data of 129 patients with acute gallstone cholecystitis were collected and all patients underwent surgical treatment, the 62 patients with onset time≤72 h were setted as treatment group,the other 67 patients with onset time ＞72 h were setted control group. Results: (1) Compared to control group, the operating time of IX) shortened significantly, intraoperative blood loss decreased and the success rate was better in the treatment group (P＜0.05). However, the postoperative drainage, complication incidence and average stay had no difference between two groups (P＞0.05). (2) In treatment group the operation time and intraoperative blood loss in patients with successful LC were much shorter and less than those in the control group (P＜0.05). Conclusion: LC could be as a top choice for the patients in the acute phase of acute gallstone cholecystitis and surgery- should perform as soon as possible. At the later stage of disease, the difficulty of surgery increases and operation success rate reduces.