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1.
目的对比分析腹腔镜术与开腹手术治疗急性结石性胆囊炎的疗效,探求治疗急性结石性胆囊炎的有效术式。方法将将244例急性结石性胆囊炎患者按随机数字表法分为观察组(n=122)与对照组(n=122),观察组应用腹腔镜胆囊切除术(LC),对照组应用开腹胆囊切除术。对比2组疗效。结果观察组手术时间显著长于对照组,术中出血量、术后住院天数、下床活动时间、肛门排气时间、疼痛分数显著低于对照组,差异有统计学意义(P<0.05)。观察组手术并发症发生率显著低于对照组,差异有统计学意义(P<0.05)。结论 LC治疗急性结石性胆囊炎尽管手术时间稍长,但患者痛苦小、并发症发生率低、术后恢复快,效果肯定。  相似文献   

2.
目的比较腹腔镜微创术与开腹术治疗急性结石性胆囊炎的临床疗效。方法回顾性分析2005年1月~2012年1月我院收治的116例急性结石性胆囊炎手术治疗患者的临床资料,其中行腹腔镜微创术(微创组)62例,开腹术(开腹组)54例,比较分析两种治疗方法的临床疗效。结果微创组在手术时间、首次肛门排气时间、下床活动时间、住院时间上明显短于开腹组,各差异均具有统计学意义(P<0.05);术中出血量、镇痛药用量及并发症方面,微创组明显少于开腹组,差异均具有统计学意义(P<0.05);两组患者术前C-反应蛋白水平差异无统计学意义(P>0.05),但微创组患者术后24 h、48小时C-反应蛋白水平明显低于开腹组,差异具有统计学意义(P<0.05);但在住院费方面,微创组高于开腹组,差异具有统计学意义(P<0.05)。结论腹腔镜微创术是治疗急性结石性胆囊炎安全、有效的方式,临床疗效优于开腹术,但仍然需要开腹术作为后备治疗方式。  相似文献   

3.
目的:探讨急诊腹腔镜胆囊切除术治疗老年急性结石性胆囊炎的临床价值。方法:回顾分析2014年1月至2017年1月为104例老年急性结石性胆囊炎患者行腹腔镜胆囊切除术的临床资料,患者分为急诊组(n=46)与延期组(n=58),对比分析两组患者临床资料、术中及术后相关指标。结果:急诊组手术时间、术中出血量、术后并发症发生率、住院总时间、住院费用、急性化脓性胆囊炎发生率明显少于延期组(P<0.05),两组中转开腹率、恢复饮食时间、留置引流管时间、术后住院时间及急性坏疽性胆囊炎发生率差异无统计学意义(P>0.05)。结论:对于入院后拟行手术治疗的老年急性结石性胆囊炎患者,与保守治疗后延期手术相比,急诊手术具有术后并发症及胆囊化脓发生率低、手术时间短、术中出血少、住院时间短、住院费用低的优点,应争取早期手术治疗。  相似文献   

4.
目的探讨腹腔镜胆囊切除术(LC)治疗急性结石性胆囊炎的效果。方法将92例急性结石性胆囊炎患者根据手术方法不同分为2组,各46例。观察组患者接受LC,对照组实施常规开腹胆囊切除术。比较2组手术时间、术中出血量、并发症发生率、术后胃肠功能恢复时间和住院时间。结果腹腔镜组中2例中转开腹,其余患者均顺利完成手术。2组手术时间差异无统计学意义(P0.05)。观察组术中出血量和术后并发症发生率、胃肠功能恢复时间及住院时间均优于对照组,差异有统计学意义(P0.05)。结论 LC治疗急性结石性胆囊炎具有创伤小,术后并发症少,恢复时间快和安全性高等优点。  相似文献   

5.
腹腔镜手术治疗急性结石性胆囊炎396例报告   总被引:1,自引:1,他引:0  
目的:总结腹腔镜手术治疗急性结石性胆囊炎的临床经验。方法:回顾分析为396例急性结石性胆囊炎患者行腹腔镜胆囊切除术的临床资料。结果:364例成功完成手术3,2例中转开腹。手术时间28~110 min,平均58 min,术中出血量10~100 ml,术后无严重并发症发生,患者均痊愈出院。结论:急性结石性胆囊炎行腹腔镜胆囊切除术安全可行。  相似文献   

6.
目的研究探讨腹腔镜技术在急性结石性胆囊炎治疗中的安全可靠性。方法通过我科2013年1月至2016年1月收治的50例急性结石性胆囊炎患者的临床资料,回顾分析腹腔镜治疗急性结石性胆囊炎的疗效。其中对照组开腹胆囊切除术(OC)40例,试验组腹腔镜胆囊切除术(LC)50例。对比分析两组的手术时间、术后恢复及并发症情况。结果 LC组的切口愈合时间及手术时间均低于OC组(P0.05)。腹腔镜胆囊切除术除5例中转开腹,余术后无胆漏、胆道狭窄等严重并发症。结论在术者拥有熟练的腹腔镜操作技术的前提下,大多数急性结石性胆囊炎患者行LC是安全可行的。与开腹手术相比,有一定的优势。但仍存在一定的手术风险。  相似文献   

7.
目的观察腹腔镜胆囊切除术(LC)治疗急性结石性胆囊炎的效果。方法将96例结石性胆囊炎患者随机分为2组,每组48例。腹腔镜组实施LC,开腹组行开腹胆囊切除术。观察2组手术时间、术中出血量、术后胃肠功能恢复时间、住院时间和术后并发症发生率等。结果腹腔镜组中1例患者因胆囊三角区严重粘连导致解剖困难,1例因胆囊床出血镜下止血困难,均中转开腹行胆囊切除术。其余2组均成功完成手术。2组患者手术时间差异无统计学意义(P0.05)。腹腔镜组术中出血量、术后胃肠功能恢复时间、住院时间、并发症发生率等均少于或短于开腹组,差异有统计学意义(P0.05)。结论 LC治疗急性结石性胆囊炎具有创伤小、并发症少及康复快等优势,但应严格掌握手术适应证和把握中转开腹手术的时机。  相似文献   

8.
目的:探讨为急性结石性胆囊炎患者行腹腔镜逆行次全胆囊切除术的临床疗效。方法:回顾分析97例急性结石性胆囊炎患者的临床资料,其中48例行腹腔镜逆行次全胆囊切除术(观察组),49例行腹腔镜逆行胆囊切除术(对照组)。结果:两组均有1例中转开腹。观察组手术时间缩短,术中出血量减少,两组相比差异有统计学意义(P<0.05);术后第1天体温、术后并发症发生率及住院时间两组差异无统计学意义(P>0.05)。结论:腹腔镜逆行次全胆囊切除术治疗慢性结石性胆囊炎疗效满意,与腹腔镜逆行胆囊切除术相比,操作更简单,手术时间更短。  相似文献   

9.
目的:探讨腹腔镜胆囊切除术治疗急性结石性胆囊炎的临床疗效.方法:160例急性结石性胆囊炎患者随机分为腔镜组与对照组,每组80例,腔镜组给予腹腔镜胆囊切除术治疗,对照组给予常规手术治疗,对比两组患者治疗效果.结果:腔镜组手术时间、住院时间均显著优于对照组[(62.11±9.21) min vs.(95.16±8.12) min,(3.21±1.11)d vs.(6.12±1.23)d](P<0.01);观察组1例中转开腹手术;腔镜组未发生并发症,对照组术中发生2例胆道损伤,术后2例出血,经对症处理均痊愈.结论:急性结石性胆囊炎患者给予腹腔镜切除胆囊术疗效可靠,安全性高.  相似文献   

10.
目的:探讨急性结石性胆囊炎急诊行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的利弊。方法:回顾分析2015年3月至2016年3月为74例急性结石性胆囊炎患者行LC的临床资料。根据手术时机分为急诊组(12 h,n=37)与延期组(12 h~1周,n=37)。结果:66例成功施行LC,8例中转开腹。急诊组术后发生肺部感染2例、切口感染1例,其中1例肺心病患者术后肺部感染较重,住院时间长,费用较高。延期组术后肺部感染1例、切口感染1例。两组患者术后并发症发生率差异无统计学意义(P0.05)。急诊组术前住院时间、术前费用、腹腔粘连、中转开腹、术中出血量、手术时间、总住院时间及住院总费用均少于延期组(P0.05)。结论:急性结石性胆囊炎行急诊LC虽然可降低费用,缩短住院时间、手术时间,减少术中出血量,但手术风险较大。可选一般情况较好、不能耐受急性胆囊炎症状、急诊手术愿望强烈的患者酌情行急诊LC。  相似文献   

11.
急性胆囊炎腹腔镜切除术式选择   总被引:12,自引:0,他引:12  
目的 :探讨急性胆囊炎行腹腔镜胆囊切除术的安全性。方法 :腹腔镜对急性胆囊炎的治疗分别选择 :胆囊大部分切除、胆囊前壁切除、胆囊完整切除三种术式。结果 :顺利完成腹腔镜胆囊切除 2 32例 ,中转手术 4例。全组无死亡病例 ,无胆道损伤、大出血等严重并发症。结论 :随着腹腔镜胆囊切除术经验积累和器械完善 ,急性化脓、坏死性胆囊炎甚至胆囊穿孔已不再是腹腔镜胆囊切除的禁忌证 ,均可在急性炎症期完成腹腔镜胆囊切除术。  相似文献   

12.
急性结石性胆囊炎的腹腔镜治疗体会   总被引:1,自引:0,他引:1  
目的:总结腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)治疗急性结石性胆囊炎的经验.方法:回顾分析为457例急性结石性胆囊炎患者行LC的临床资料.结果:432例手术成功,25例中转开腹,患者均痊愈出院.结论:为急性结石性胆囊炎患者施行LC安全可行,成功的关键在于手术技巧和中转开腹指征...  相似文献   

13.
目的:总结腹腔镜手术治疗急性结石性胆囊炎的临床经验。方法:回顾分析为452例急性结石性胆囊炎患者行腹腔镜手术的临床资料,其中发作72h以内346例,72h以上106例。结果:本组2000年10月前共142例,中转11例,2000年10月以后共310例,中转6例;中转病例中3例系Mirizzi综合征,1例因胆总管继发结石中转行胆道探查"T"管引流术,3例术中胆管损伤,7例胆囊及三角严重粘连,3例术中大出血。术后再手术4例,其中3例术后胆漏,1例术后出血。结论:随着腹腔镜技术的成熟,手术适应证进一步扩大,急性结石性胆囊炎行腹腔镜胆囊切除术是安全可行的。  相似文献   

14.
Background: Acute cholecystitis carries the highest incidence of conversion from planned laparoscopic cholecystectomy to open surgery due to unclear anatomy, excessive bleeding, complications, or other technical reasons. Methods: Laparoscopic tube cholecystostomy was performed instead of immediate conversion to laparotomy in 9 patients with acute cholecystitis after unsuccessful attempts at laparoscopic dissection. Elective laparoscopic cholecystectomy was done 3 months later. Results: Following this approach eight patients were treated successfully. After 3 months the acute process had subsided sufficiently to allow a safe laparoscopic cholecystectomy. One additional patient died of acute leukemia 6 weeks after cholecystostomy. Before adopting this technique we subjected 171 patients with acute calculous cholecystitis to laparoscopic cholecystectomy; there was an 11% (19 cases) rate of conversion. Since cholecystostomy has begun to be offered as an alternative to conversion, 121 patients with acute cholecystitis have had laparoscopic cholecystectomy and only 2 cases (1.5%) have been converted to immediate open cholecystectomy. Conclusions: We recommend the alternative of performing a cholecystostomy with delayed laparoscopic cholecystectomy instead of conversion to open procedure when facing a case of acute cholecystitis not amenable to laparoscopic cholecystectomy.  相似文献   

15.
OBJECTIVE: This article determined which preoperative data correlated with successful completion of a laparoscopic cholecystectomy in patients with acute cholecystitis. SUMMARY BACKGROUND DATA: Although laparoscopic cholecystectomy is the procedure of choice in chronic cholecystitis, its use in acute cholecystitis may be associated with higher costs and complication rates. It is not known which patients with acute cholecystitis are likely to require conversion to open cholecystectomy based on preoperative data or if a cooling-off period with medical therapy can diminish inflammation and increase the chance of successful laparoscopic cholecystectomy. METHODS: All laparoscopic cholecystectomies done by the authors between 10/90 and 2/92 were reviewed. Data on cases of acute cholecystitis were prospectively collected on standardized data forms. RESULTS: Twenty of 281 laparoscopic cholecystectomies were done for acute cholecystitis; 7/20 patients with acute cholecystitis required conversion to open cholecystectomy compared with 6/281 patients undergoing elective operation for chronic cholecystitis. In patients with acute cholecystitis the interval from admission to cholecystectomy in the successful cases was 0.6 days vs. 5 days in the cases requiring conversion to open cholecystectomy (p = .01). Cases requiring conversion to open cholecystectomy also had higher WBC (14.0 vs. 9.0, p < .05), alkaline phosphatase (206 vs. 81, p < .02, and APACHE II scores (10.6 vs. 5.1, p < .05). Ultrasonographic findings such as gallbladder distention, wall thickness, and pericholecystic fluid did not correlate with the success of laparoscopic cholecystectomy. Patients converted from laparoscopic to open cholecystectomy required more operating room time (120 min vs. 87 min, p < .01) and more postop hospital days (6 vs. 2, p < .001). CONCLUSIONS: Laparoscopic cholecystectomy for acute cholecystitis should be done immediately after the diagnosis is established because delaying surgery allows inflammation to become more intense, thus increasing the technical difficulty of laparoscopic cholecystectomy.  相似文献   

16.
目的:探讨腹腔镜手术治疗方法在老年人急性胆囊炎的临床疗效和安全性。方法:将2006年1月—2012年5月138例急性胆囊炎老年患者随机分成两组,分别行腹腔镜胆囊切除术(腔镜组,70例)和剖腹胆囊切除术(开腹组,68例),对比两组患者手术时间、肠功能恢复时间、住院时间、术后并发症。结果:腔镜组手术时间、肠功能恢复时间以及住院时间均短于开腹组(均P<0.05),两组术中出血量差异无统计学意义(P>0.05),腔镜组术后并发症明显少于开腹组(P<0.05)。结论:腹腔镜手术治疗方法在老年人急性胆囊炎中具有理想疗效,手术时机的选择与操作的熟练程度是治疗成功的关键。  相似文献   

17.
腹腔镜手术治疗急性胆囊炎50例分析   总被引:5,自引:1,他引:4  
目的:探讨腹腔镜治疗急性胆囊炎的可行性。方法:采用腹腔镜技术对急性胆囊炎进行手术治疗。结果:50例患者均治愈,其中2例中转开腹处理,无并发症发生。结论:只要熟练掌握腹腔镜的操作技术,对急性胆囊炎都可以采用腹腔镜治疗。  相似文献   

18.
Early laparoscopic cholecystectomy for acute cholecystitis: A safe procedure   总被引:13,自引:0,他引:13  
Acute cholecystitis is increasingly managed by laparoscopic cholecystectomy. Some reports have shown conversion and complication rates that are increased in comparison to elective laparoscopic cholecystectomy. This study reviews the combined experience of two hospitals where the intention was to perform early laparoscopic cholecystectomy for acute cholecystitis. A total of 152 cases of laparoscopic cholecystectomy for acute cholecystitis (evidence of acute inflammation clinically and pathologically) were identified. Conversion to open cholecystectomy was required in 14 cases (9%) in the total series. Laparoscopic cholecystectomy was performed within 2 days of admission in 76% (115 of 152) of patients. Conversion was significantly less likely in patients undergoing laparoscopic cholecystectomy within 2 days of admission (4 of 115) compared to those undergoing surgery beyond 2 days (10 of 37; P <0.0001). Eleven patients (7%) had postoperative complications; however, there were no cases of injury to the biliary system and no perioperative deaths. This series shows that laparoscopic cholecystectomy can be performed safely in patients with acute cholecystitis and suggests that early laparoscopic cholecystectomy is preferable to delaying surgery. Although the conversion rate to open surgery is higher than for elective cholecystectomy, the majority of patients (91 %) still derive the well-recognized benefits of laparoscopic cholecystectomy. Early laparoscopic cholecystectomy is an acceptable approach to acute cholecystitis for the experienced laparoscopic surgeon.  相似文献   

19.
目的:探讨高原农业地区体力劳动者急性结石性胆囊炎发作行腹腔镜胆囊切除术(laparoscopic cholecytectomy,LC)的疗效及应用价值。方法:90例患者均行四孔法LC。放置引流管23根。结果:90例除1例中转开腹外,余腹腔镜手术均获成功。术后3~5d拔除引流管,无切口感染,痊愈出院。平均住院6.5d。随访表明,恢复劳动快,无并发症发生。结论:高原农业地区家庭主要劳动者急性结石性胆囊炎发病率高,行LC康复快,疗效好,对体力无影响,是一种切实可行的手术治疗方法。  相似文献   

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