腹腔镜手术治疗急性胆囊炎的手术时机与疗效探讨

目的探讨腹腔镜胆囊切除术治疗急性胆囊炎的手术时机与疗效。方法回顾性分析该院2000年1月~2003年12月间收治的137例行腹腔镜手术的急性胆囊炎病例临床资料。依据发病至手术的时间长短分成早期手术组(48 h内手术,n=43)和晚期手术组(48 h后手术,n=94),并比较两组间各项临床资料。结果早期手术组和晚期手术组的中转开腹率分别为2.3%和17.0%(P<0.05),早期手术组的手术时间,术后住院天数和总住院时间明显短于晚期手术组(P<0.01)。结论腹腔镜手术是治疗急性胆囊炎安全有效的术式。自发病起48 h内施行腹腔镜手术是最佳手术时机,具有极低的中转开腹率,更短的手术时间、术后住院天数和总住院时间等优点。

Efficacy and timing of laparoscopic cholecystectomy for acute cholecystitis

Objective: To explore the efficacy and timing of laparoscopic cholecystectomy (LC) for acute cholecystitis. Methods: The clinical data of 137 cases were retrospectively analyzed. The patients undergoing LC were divided into two groups based on the length of time from onset of symptoms to surgical intervention: less than 48 hours in the early LC (ELC) group (n=43) and more than 48 hours in the delayed LC (DLC) group (n=94). Results: Comparing the two groups, the conversion rates to an open procedure were 2.3% in ELC group and 17.0% in DLC group respectively (P<0.05). The operative time, postoperative hospitalization and total hoapital stay were significantly reduced in ELC group (P<0.01). Conclusions: LC is a safe and effective technique for treatment of acute cholecystitis. Patients treated within 48 hours of onset of symptoms experience a lower conversion rate to an open procedure, shorter operative time and reduced hospitalization.