CAJ | 학술논문

目的：探讨伴有 Calot 三角冰冻样粘连的急性坏疽性胆囊炎行腹腔镜胆囊切除术的临床效果。方法沈阳军区总医院肝胆外科2008年8月—2013年8月治疗伴有 Calot 三角冰冻样粘连的急性坏疽性胆囊炎77例，依据手术方式分为观察组40例和对照组37例。观察组经腹腔镜实施胆囊切除术，对照组给予开腹手术。观察两组手术时间、术中出血量、引流量、下床活动时间、胃肠功能恢复时间及住院天数，比较两组并发症发生率。结果观察组手术时间、下床活动时间、胃肠功能恢复时间、住院天数均短于对照组，术中出血量和术后引流量均少于对照组(P <0．05)。两组并发症发生率比较差异无统计学意义(P >0．05)。结论腹腔镜手术治疗伴有 Calot 三角冰冻样粘连的急性坏疽性胆囊炎损伤小，术后恢复快，但术式还应依据患者具体情况选择。
목적：탐토반유 Calot 삼각빙동양점련적급성배저성담낭염행복강경담낭절제술적림상효과。방법침양군구총의원간담외과2008년8월—2013년8월치료반유 Calot 삼각빙동양점련적급성배저성담낭염77례，의거수술방식분위관찰조40례화대조조37례。관찰조경복강경실시담낭절제술，대조조급여개복수술。관찰량조수술시간、술중출혈량、인류량、하상활동시간、위장공능회복시간급주원천수，비교량조병발증발생솔。결과관찰조수술시간、하상활동시간、위장공능회복시간、주원천수균단우대조조，술중출혈량화술후인류량균소우대조조(P <0．05)。량조병발증발생솔비교차이무통계학의의(P >0．05)。결론복강경수술치료반유 Calot 삼각빙동양점련적급성배저성담낭염손상소，술후회복쾌，단술식환응의거환자구체정황선택。
Objective To investigate the clinical effects of subtotal cholecystectomy under laparoscopes in treat-ment of acute laparoscopic cholecystectomy complicated by Calot triangular frozen sticky clay. Methods A total of 77 patients with acute laparoscopic cholecystectomy complicated by Calot triangular frozen sticky clay during August 2008 and August 2013 were divided into study group (n = 40) and control group (n = 37) according to the operative methods. The study group was treated with laparoscopic cholecystectomy, while the control group was treated with open operation treatment. The operation time, volume of intraoperative blood loss, drainage volume, ambulatory time, recovery time of gastrointestinal function and hospitalization days in the two groups were observed, and the incidence rate of complications in the two groups was also compared. Results In study group, the operation time, ambulatory time, recovery time of gastrointestinal function and hospitalization days were significantly shorter, and volumes of intraoperative blood loss and postoperative drainage were significantly less than those in the control group (P < 0. 05). The difference in incidence rate of complications in the two groups was not statistically significant (P > 0. 05). Conclusion Laparoscopic operation in treatment of acute laparoscopic cholecystectomy complicated by Calot triangular frozen sticky clay can achieve the results of minor injury and quick recovery, but clinicians should select appropriate operative method based on the patients'condi-tions.