急性胆囊炎腹腔镜胆囊切除术135例体会

目的总结急性胆囊炎行腹腔镜胆囊切除术的经验体会。方法对2015年1月至2017年2月本院135例急性胆囊炎患者行腹腔镜胆囊切除术的进行回顾分析,根据患者急性胆囊炎感染严重程度分为重度感染组(65例)和轻度感染组(70例),采用SPSS 19.0统计软件处理数据。两组患者术中术后的各项指标,如手术时间、术中出血、住院天数等采用t检验;术后并发症率、中转开腹率采用卡方检验。P0.05表示差异有统计学意义。结果 130例患者成功完成腹腔镜胆囊切除术,5例患者中转开腹,均为重度感染组,中转开腹率7.7%;重度感染组患者手术时间、术中出血量、住院天数均多于/大于轻度感染组患者,差异均有统计学意义(P0.05)。术后并发症率重度感染组(12.3%)明显高于轻度感染组(7.1%),差异均有统计学意义(P0.05);两组均无胆管损伤、胆漏等严重并发症及死亡病例。结论急性胆囊炎行腹腔镜手术安全、可行。

Laparoscopic cholecystectomy for acute cholecystitis: with a report of 135 cases

Objective To summarize the experience of laparoscopic cholecystectomy for acute cholecystitis . Methods 135 cases with acute cholecystitis from January 2015 to december 2017 underwent laparoscopic cholecystectomy .The clinical data were retrospectively analyzed .The patients were divided into severe infection group (65 cases) and mild infection group (70 cases) according to the infection severity of acute cholecystitis.All those data were analyzed for statistics in SPSS 19.0Intraoperative and postoperative data, such the operation time, intraoperative blood loss, hospital stay, such are compared with method of t test.The postoperative complications and the rate of conversion to laparotomy were analyzed with method of chi-square test.P<0.05 was considered statistically significant . Results The operation was successfully performed in 135 cases.5 cases ( all in severe infection group ) were converted to open surgery .The conversion rate was 7.7%.The operation time, intraoperative blood loss, hospital stay, and postoperative complications in severe infection group were obviously higher than that in mild infection group (P<0.05). Postoperative complications rate in severe infection group (12.3%) was significantly higher than that in mild infection group (7.1%) (P<0.05).No bile duct injury, bile leakage, other serious complications and deaths occurred in the two groups . Conclusions Laparoscopic cholecystectomy is safe and feasible for acute calculus cholecystitis .