腹腔镜胆囊切除术与传统开腹术治疗急性结石嵌顿性胆囊炎的临床疗效比较

目的]对比腹腔镜胆囊切除术（LC）与传统开腹术（OC）治疗急性结石嵌顿性胆囊炎的临床效果.方法]回顾性分析2011年5月至2013年12月在本院手术治疗的158例急性结石嵌顿性胆囊炎临床资料.在知情同意的原则下,由患者自主选择治疗方案,将其分为LC治疗的观察组（82例）和OC治疗的对照组（76例）.比较两组患者手术成功率、术中出血量、手术时间、住院时间、并发症率等.结果]观察组手术成功率98.9％,1例患者中转开腹手术;对照组手术成功率100.0％,略优于观察组,但差异无统计学意义（P＞0.05）;观察组手术时间及住院时间为（67.1±14.8）min和（4.9±1.9）d,均明显较对照组（92.5±17.8）min和（7.9±2.0）d短;术中出血量为（43.7±12.4）mL,明显较对照组（77.9±16.5）mL少;术后并发症发生率为4.9％,明显较对照组19.7％低,两组间上述各指标对比差异均有统计学意义（P＜0.05）.结论]在急性结石嵌顿性胆囊炎的手术治疗中,LC手术较OC手术有显著的优势,值得临床推广应用.

Comparative Study on Clinical Efficacy Between Laparoscopic Cholecystectomy and Traditional Open Cholecystectomy for the Treatment of Acute Calculus Incarcerated Cholecystitis

Objective]To compare the clinical efficacy between laparoscopic cholecystectomy（LC） and traditional open cholecystectomy（OC） for the treatment of acute calculus incarcerated cholecystitis.Methods] Clinical data of 158 patients with acute calculus incarcerated cholecystitis undergoing the operation in our hospital from May 2011 to Dec.2013 were analyzed retrospectively.On the basis of the principle of the informed consent,patients chose the operation scheme by themselves.All patients were divided into the observation group（LC treatment,n =82） and the control group（OC treatment,n =76）.The successful rate of operation,intraoperative blood loss,operation time,hospitalization time and complications rate were compared between two groups.Results]The successful rate of operation in the observation group was 98.9％,and 1 patients converted to the OC.The successful rate of operation in the control group was 100％,which was slightly better than the observation group,but there was no significant difference（P ＞0.05）.The operation time and hospitalization time of the observation group were （67.1 ± 14.8）min and （4.9±1.9） d respectively,which were obviously shorter than those in control group（92.5± 17.8）min and （7.9±2.0）d,respectively].The intraoperative bleeding volume of the observation group was （43.7± 12.4）ml,which was obviously less than that in the control group（77.9 ±16.5） mL].The incidence of postoperative complications in the observation group was 4.9 ％,which was obviously lower than that in the control group（19.7 ％）.There were significant differences in these above indexes between two group（P ＜0.05）.Conclusion] Compared with OC operation,LC operation for the treatment of acute calculus incarcerated cholecystitis has significant advantages and is worthy of clinical promotion.