CAJ | 학술논문

目的通过与延期腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果对比,评估急诊腹腔镜胆囊切除术治疗急性结石性胆囊炎的可行性和安全性.方法将109例急性结石性胆囊炎患者随机分成两组:急诊手术组(55例)和延期手术组(54例,由于各种原因最终实行延期手术的共40例).急诊手术组55例依据实施手术时间迟早分为:72小时内手术组(37例)和72小时后手术组(18例).比较各组手术时间、胆道损伤、中转开腹、住院时间、术后并发症、围手术期死亡率.结果急诊手术组与延期手术组的手术时间分别为(91±26.2)min、(104±34.7)min;胆道损伤发生例数分别为1例、0例;中转开腹发生例数分别为3例、4例;住院时间分别为(8±2.7)天、(8±1.2)天;术后并发症发生例数分别为2例、1例.两组上述参数比较均无显著性差异(P＞0.05).急诊手术在72小时内开展与72小时后开展手术时间分别为(89±13.4)min、(104±34.7)min,两者比较有显著性差异(P＜0.05);其中转开腹例数分别为0例、3例,两者比较有显著性差异(P＜0.05).无围手术期死亡病例.结论急诊腹腔镜胆囊切除术是治疗急性结石性胆囊炎的安全可行的方法,手术时间宜愈早愈好.
목적 통과여연기복강경담낭절제술치료급성결석성담낭염적효과대비,평고급진복강경담낭절제술치료급성결석성담낭염적가행성화안전성.방법 장109례급성결석성담낭염환자수궤분성량조:급진수술조(55례)화연기수술조(54례,유우각충원인최종실행연기수술적공40례).급진수술조55례의거실시수술시간지조분위:72소시내수술조(37례)화72소시후수술조(18례).비교각조수술시간、담도손상、중전개복、주원시간、술후병발증、위수술기사망솔.결과 급진수술조여연기수술조적수술시간분별위(91±26.2)min、(104±34.7)min;담도손상발생례수분별위1례、0례;중전개복발생례수분별위3례、4례;주원시간분별위(8±2.7)천、(8±1.2)천;술후병발증발생례수분별위2례、1례.량조상술삼수비교균무현저성차이(P＞0.05).급진수술재72소시내개전여72소시후개전수술시간분별위(89±13.4)min、(104±34.7)min,량자비교유현저성차이(P＜0.05);기중전개복례수분별위0례、3례,량자비교유현저성차이(P＜0.05).무위수술기사망병례.결론 급진복강경담낭절제술시치료급성결석성담낭염적안전가행적방법,수술시간의유조유호.
Objective Through comparing the curative effects of urgent and delayed laparoscopic cholecystectomy (LC) on acute calculous cholecystitis,evaluating the safety and feasibility of urgent LC for acute calculous cholecystitis.Mthods 109 patients with a clinic diagnosis of acute calculous cholecystitis were randomly assigned to urgent LC (urgent group,n=55) or delayed interval surgery after initial medical treatment (delayed group,n=54,but with some reasons there only 40 patients were treated by delayed surgery).According to the operation time within 72 hours of admission or not,the urgent group was divided into two groups:37 patients in Group Ⅰ (within 72 hours) and 18 patients in Group Ⅱ (beyond 72 hours).The operation time,bile duct injury,conversion to open cholecystectomy,total hospital stay,postoperative complications and mortality of the perioperative period were compared.Results There was no difference between the urgent LC group and delay LC group in the operating time[ (91±26.2 )min versus( 104±34.7 )min],bile duct injury (1 case versus 0 case),conversion to open cholecysteetomy (3case versus 4 case),total hospital stay[ (8±2.7) day versus( 8±1.2 )day]and postoperative complications (2 case versus 1 case).The delay in performing an LC beyond 72 h affected the operating time and conversion to open eholeeystectomy.No death in perioperative period.Conclusion Urgent LC for acute calculous cholecystitis can be performed safely and successfully.Earlier urgent LC has a beneficial impact for patients.