基于快速康复外科的腹腔镜胆囊切除和日间手术对比研究

目的：探讨基于快速康复外科的腹腔镜胆囊切除和日间手术的特点。方法：将快速康复外科指导下的于2017年4月1日至2018年3月30日行腹腔镜胆囊切除术的99例患者根据手术方式分为日间手术组（43例）和常规组（56例），分析2组手术时间、再入院病例、住院相关费用的差异。结果：日间手术组手术时间（38.55±11.52）min，住院费用（9 692±1 279）元，药费（1 628±515）元，检查治疗费（8 064±1 070）元；常规组住院时间（5.52±2.24）d，手术时间（42.03±18.82）min，住院费用（12 184.03±3 576）元，药费（2 610±806.56）元，检查治疗费（9 574±3 345）元。2组间手术时间和再入院例数差异无统计学意义（P＞0.05），而住院费用、药费和检查治疗费差异均有统计学意义（P＜0.01）。结论：腹腔镜胆囊切除日间手术不增加术后并发症的发生，且能显著降低住院费用及药费、检查治疗费。

Comparative study of ambulatory and conventional laparoscopic cholecystectomy based on enhanced recovery after surgery

Objective: To investigate the characteristics of ambulatory and conventional laparoscopic cholecystectomy based on enhanced recovery after surgery. Methods: A total of 99 patients underwent laparoscopic cholecystectomy based on ERAS from April 1, 2017 to March 30, 2018, were divided into two groups: ambulatory laparoscopic cholecystectomy group (ALC, n=43) and conventional laparoscopic cholecystectomy (CLC, n=56). The data of the patients’ operation time, readmission cases and the related expenses were analyzed. Results: In ALC group, the operation time was (38.55±11.52) min, hospitalization expense was (9 692±1 279) Yuan, the cost for medicine was (1 628±515) Yuan, and the cost for tests and treatment was (8 064±1 070) Yuan. In CLC group, the operation time was (42.03±18.82) min, hospitalization expense was (12 184±3 576) Yuan, the costs for medicine was (2 610±806) Yuan, and the tests and treatment was (9 574±3 345) Yuan. There was no significant difference in the operation time (min) and re-hospitalization (cases) (P>0.05) between the two groups, but there was significant difference in the cost for hospitalization, medicine, tests and treatment (P<0.01). Conclusion: These findings indicate that ALC does not increase postoperative complications, and could significantly reduce the relevant expenses.