腹腔镜胆囊大部切除术治疗复杂胆囊结石的临床分析

目的:探讨腹腔镜胆囊大部切除术治疗复杂胆囊结石的应用价值。方法:回顾分析近10年259例复杂胆囊结石患者的临床资料。将患者随机分为两组,实验组146例,行腹腔镜胆囊大部切除术;对照组113例,行开腹胆囊大部切除术。对比分析两组手术时间、术中出血量、术后下床活动时间、开始进食时间、住院时间、术后胆漏等并发症。结果:实验组患者手术时间显著长于对照组,两组相比差异有统计学意义(P<0.05);实验组术中出血量、术后下床活动时间、开始进食时间、住院时间、术后胆漏等并发症发生率均优于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜胆囊大部切除术治疗复杂胆囊结石具有患者创伤小、术后康复快、并发症发生率低等优点,手术的成功取决于术者的技术水平,只有成熟精湛的技术与丰富的手术经验相结合才能体现其价值。

The clinical analysis of laparoscopic subtotal cholecystectomy in treatment of complicated cholecystolithiasis

Objective:To investigate the clinical application value of laparoscopic subtotal cholecystectomy in treatment of complicated cholecystolithiasis.Methods:The clinical data of 259 patients with complicated cholecystolithiasis who underwent laparoscopic subtotal cholecystectomy in nearly 10 years was analyzed retrospectively.These patients were randomly divided into 2 groups:the experimental group contained 146 cases of laparoscopic surgery and the control group contained 113 cases of open surgery.The operative time,blood loss,postoperative ambulation time,proper time of intaking food,the average hospital stay,postoperative incidence of biliary leakage and other complications were compared between two groups respectively.Results:The operative time of experimental group was significantly longer than the control group,the difference was statistically significant(P<0.05);the operative time,blood loss,postoperative ambulation time,proper time of intaking food,the average hospital stay,postoperative incidence of biliary leakage and other complications of experimental group was better than the control group,the differences were statistically significant(P<0.05).Conclusions:The laparoscopic subtotal cholecystectomy in treatment of complicated cholecystolithiasis has a certain clinical value because of the advantages of less trauma,faster recovery and lower incidence of postoperative complications,it is worth promoting.