腹腔镜胆囊切除术治疗急性结石性胆囊炎手术时机探讨

目的探讨急性结石性胆囊炎行腹腔镜胆囊切除术的最佳手术时机。方法分析行腹腔镜胆囊切除术治疗的急性结石性胆囊炎106例患者的临床资料，其中发病距手术时间≤72h的患者56例设为观察组，发病距手术时问：〉72h的患者50例设为对照组，对比两组平均手术时间、中转开腹率、术后并发症发生率、疼痛时间、肛门排气时间及平均住院时间等观察指标。结果观察组的平均手术时间、平均住院时间、术后肛门排气时间及术后疼痛时间均明显短于对照组（P〈0．05），中转开腹率和并发症发生率均低于对照组（P〈0．05）。结论急性结石性胆囊炎LC宜及早施行，最好在发病72h以内，只要掌握正确时机，适时中转手术，急性结石性胆囊炎LC是安全可行的。

Investigation of operation opportunity of laparoscopic cholecystectomy to treat acute lithic cholecystitis

Objective To investigate the best operation opportunity of laparoscopic cholecysteetomy to treat acute lithic cholecystitis. Methods Retrospective analysis the clinical data of 106 cases of acute lithic cholecystitis treated by laparoscopic cholecystectomy. 56 cases whose time from onset to operation ≤72h were divided into observation group, other 50 cases whose time from onset to operation 〉72h were divided into control group. Observation indexes including average operation time, the rate of conversion to open surgery, complication rate, pain time, anal exsufflation time and average hospitalization time were compared between these two groups. Results The average operation time, average hospitalization time, anal exsufflation time and pain time of observation group were shorter than control group（P〈0. 05）. The rate of conversion to open surgery and complication rate of observation group were lower than control group（P〈 0.05）. Conclusion The laparoscopic choleeystectomy of acute lithic cholecystitis should be carried out early. The best operation time is within 72 hours. The laparoscopic cholecystectomy of acute lithie cholecystitis is safety that doctors master correct time and conversion to open surgery in time.