胆源性胰腺炎手术时机的探讨

目的探讨胆源性胰腺炎（ＧＰ）的手术时机。方法采用统计学方法分析了５３例ＧＰ的临床资料。结果早期手术组（入院４８小时内）及延期手术组（入院４８小时后）并发症发生率分别为２９．２０％和３．５０％（Ｐ＜０．０５）;死亡率分别为８．３０％和０（Ｐ＜０．０５）。ＡＰＡＣＨＥ－Ⅱ记分≤８的轻型ＧＰ死亡率与手术时机无关,但早期手术组的并发症发生率（１１．１０％）及胆总管探查率（９１．７０％）明显高于延期手术组（Ｐ＜０．０５）。ＡＰＡＣＨＥ－Ⅱ记分＞８的重型ＧＰ并发症发生率及死亡率与手术时机有关,即早期手术组明显高于延期手术组。结论轻型ＧＰ应待急性发作缓解后延期手术;重型ＧＰ应采用延期与个体化相结合的处理原则。     

尿素动力学模型在持续性非卧床腹膜透析中的应用

对２０例ＥＳＲＤ患者先后给予持续性非卧床膜腹膜透析（ＣＡＰＤ）１Ｌ×５／ｄ和２Ｌ×４／ｄ方案透析，测定其尿素清除指数（ＫＴ／Ｖ）和标化每日蛋白质分解率（ＮＰＣＲ），同时应用１２个临床参数对两方案进行疗效评价．结果显示由ＩＬ×５／ｄ改为２Ｌ×４／ｄ时，ＫＴ／Ｖ和ＮＰＣＲ分别上升０．７４±０．２１和０．１２±０．０９（Ｐ＜０．００１），临床有效率上升８０％（Ｐ＜０．００５）；ＮＰＣＲ和ＫＴ／Ｖ呈正相关（ｒ＝０．４９，Ｐ＜０．０５）．ＮＰＣＲ与每日蛋白质摄入量（ＤＰＩ）呈高度正相关（ｒ＝０．９１，Ｐ＜０．００１），ＫＴ／Ｖ与临床评分也呈正相关（ｒ＝０．６１，Ｐ＜０．０１）．结果表明尿素动力学模型对评价ＣＡＰＤ治疗具有重要意义．     

重症胰腺炎手术指征和手术时机的探讨

目的 探讨重症且腺炎的手术指征和手术时机。方法 回顾性分析８２例重症胰腺炎的治疗情况,其中行非手术治疗１０例、早期手术４４例、延期手术２８例。结果 本组总并发症发生率为２４％、总病死率为１８％。非手术组１０例均痊愈,并发症发生率为１０％;早期手术组死亡５例,并发症经和病死率分别为１４％和１１％;延期手术组死亡１０例,并发症发生率和病死率分别为４６％和３６％,两组相比差异有显著意义（Ｐ＜０.０１、Ｐ＜０.０５）。延期手术组中,无明显感染者其并发症发生率和病死率明显低于有严重感染及重要器官功能不全者（Ｐ＜０.０１、Ｐ＜０.０５）。结论 早期手术治疗对于一些重症胰腺炎患者仍然是必需的。胰腺坏死广泛者宜在发生严惩感染前进行手术。     

不同心脏病人心肺转流期间肺顺应性的动态观察

本文观察了两组心内直视手术病人心肺转流前后肺顺应性的动态变化。结果发现先心组病人（ｎ＝１４）转流期间胸肺顺应性（Ｃｓ）和动态肺顺应性（Ｃｄ）均显著降低（Ｐ＜０．０１），停机２０ｍｉｎ和术毕时仍低于转流前（Ｐ＜０．０１）；瓣膜组（ｎ＝１１）Ｃｓ、Ｃｄ值转流期间亦同样降低（Ｐ＜０．０１），但转流后期至术毕渐回升至对照水平（Ｐ＞０．０５）。认为两类病人不同的肺部病理生理特点是造成转流中、后期肺顺应性呈不同变化的基础。体外循环本身可造成两类病人肺顺应性的降低，引起上述变化的确切因素仍待进一步探讨。     

慢性肾功能衰竭患者的高同型半胱氨酸血症

目的 研究慢性肾功能衰竭（ＣＲＦ）患者血浆同型半胱氨酸（Ｈｃｙ）水平、影响因素以及与心、脑血管疾病的关系。方法 采用荧光偏振免疫分析法测定１６０例ＣＲＦ患者血浆总同型半胱氨酸（ｔＨｃｙ）水平，以３１例冠心病患者和４５例正常人为对照。结果 以正常组血浆ｔＨｃｙｘ±２ｓ为９５％可信度上限，ＣＲＦ患者高同型半胱氨酸血症的发生率为８２．５０％，明显高于冠心病组（２２．５８％）（Ｐ＜０．０１）；血液透析（ＨＤ）组血浆ｔＨｅｙ水平［（２４．１３±１２．６８）μｍｏｌ／Ｌ，ｎ＝７３］明显高于持续性非卧床腹膜透析（ＣＡＰＤ）组［（１６．４３ ±５．５８）μｍｏｌ／Ｌ，ｎ＝１９］、冠心病组［（１１．１３±４．９７）μｍｏｌ／Ｌ，ｎ＝３１］以及正常组（７．９７±２．６５）μｍｏｌ／Ｌ，ｎ＝４５，Ｐ均＜０．０１。９２例透析治疗的ＣＲＦ患者中有明确心、脑血管病者的血浆ｔＨｃｙ水平［（２７．１２±１５．９４）μｍｏｌ／Ｌ，ｎ＝３０］明显高于无此类病史的患者［（２０．１７±８．７１）μｍｏｌ／Ｌ，ｎ＝６２］。未经透析的 ＣＲＦ患者血浆 ｔＨｃｙ水平与内生肌酐清除率呈负相关（ｒ＝－０．３７４，Ｐ＜０．０１），与患者年龄、血葡萄糖、血脂及血浆白     

外源性胰岛素对豚鼠胆汁酸代谢的影响及诱发胆结石形成的实验研究

作者通过给豚鼠注射外源性胰岛素，观察官对豚鼠的胆汁酸代谢、肝脏形态及胆石形成的影响。结果发现：①实验组（ｎ＝１２）７只豚鼠有胆石形成，成石率５８％，而对照组（ｎ＝１５）中仅１只有胆石形成，成石率６．７％，两组间有显著性差异（Ｐ＜０．０５）；②实验组豚鼠肝脏中央静脉周围有空泡变性及脂肪细胞沉积，对照组豚鼠则少见；③实验组豚鼠胆囊胆汁中牛磺鹅脱氧胆酸（ＴＣＤＣＡ）与甘氨鹅脱氧胆酸（ＧＣＤＣＡ）分别为０．５９７±０．３９ｍｇ／ｍｌ与２．４２１±１．５９ｍｇ／ｍｌ，而对照组分别为０．７５７±０．４３ｍｇ／ｍｌ与３．２６５±２．４７ｍｇ／ｍｌ，两组间也有显著性差异（Ｐ＜０．０１）。上述实验结果表明，外源性胰岛素可引起肝脏的空泡变性，进而使胆汁中结合胆汁酸含量降低，促进胆石形成。     

氨甲酰血红蛋白在评价血液透析充分性中的意义

目的　评价氨甲酰血红蛋白（ Ｃａｒ Ｈｂ） 在血液透析（ Ｈ Ｄ） 充分性中的意义。方法　用高效液相色谱法测定正常对照组３６ 例,非透析慢性肾功能衰竭５１ 例和 Ｈ Ｄ 患者３０ 例 Ｃａｒ Ｈｂ 含量（ 以每克血红蛋白含氨甲酰缬氨酸微克数,μｇ Ｃ Ｖ／ｇ Ｈｂ 表示） 。 Ｈ Ｄ 组 Ｃａｒ Ｈｂ 含量与尿素清除指数（ Ｋｔ／ Ｖ） 、尿素降低率（ Ｕ Ｒ Ｒ） 、平均时间尿素浓度（ Ｔ Ａ Ｃｕｒｅａ） 和校正蛋白质分解率（ｎ Ｐ Ｃ Ｒ） 作相关分析。结果　与对照组（３００ ±６１） 比较, Ｈ Ｄ 组 Ｃａｒ Ｈｂ 含量（１０２５ ±２８９） 显著升高（ Ｐ＜ ００１） ,但显著低于非透析组（１３９９ ±５２０）（ Ｐ＜ ００１） ; Ｋｔ／ Ｖ≤１１ 组 Ｃａｒ Ｈｂ 显著高于 Ｋｔ／ Ｖ＞ １１ 组［（１３５０ ±３１０）ｖｓ．（８８６±１２０） , Ｐ＜ ００１］ ; Ｃａｒ Ｈｂ 与 Ｋｔ／ Ｖ, Ｕ Ｒ Ｒ 呈负相关,但与 Ｔ Ａ Ｃｕｒｅａ 正相关。当 Ｋｔ／ Ｖ＞ １１ ,ｎ Ｐ Ｃ Ｒ＜ １０ ｇ· Ｋｇ１·ｄ１ 组 Ｃａｒ Ｈｂ 显著高于ｎ Ｐ Ｃ Ｒ≥１０ ｇ· Ｋｇ１·ｄ１ 组［（９６５ ±８３）ｖｓ．（８１５ ±１０４） , Ｐ     

胆汁酸代谢经典途径酶基因表达与豚鼠胆石病关系的研究

目的：研究豚鼠肝脏胆汁酸代谢经典途径关键酶──胆固醇７α一羟化酶（ＣＹＰ７ａｌ）和甾醇１２α－羟化酶（ＣＹＰ８ｂ１） 的基因表达与胆汁脂质含量及胆固醇结石形成的关系。方法：采用点杂交技术检测对照组（ｎ＝８）（普通豚鼠饲料喂 养）、未成石组（ｎ＝１３）和成石组豚鼠（ｎ＝９）（致石饲料喂养）肝脏ＣＹＰ７ａｌ和ＣＹＰ８ｂ１ ｍＲＮＡ的相对含量,并对三组豚 鼠胆汁脂质成份进行检测和分析。结果： １、与对照组豚鼠（ｎ＝８）相比,成石组豚鼠（ｎ＝８）肝脏ＣＹＰ７ａ１ ｍＲＮＡ的相对 含量显著减少（０．３９±０．１９比０．７３±０．３６,Ｐ＝０．０３）,ＣＹＰ７ａ１的ｍＲＮＡ相对量与胆汁胆固醇摩尔浓度、胆固醇在胆汁胆 固醇、胆汁酸和磷脂三者中的摩尔百分数、胆汁中胆汁酸摩尔浓度皆无明显相关。２、对照组（ｎ＝８）、未成石组（ｎ＝８）和 成石组豚鼠（ｎ＝８）肝脏ＣＹＰ８ｂ１ ｍＲＮＡ的相对含量无显著差异。３、未成石组（ｎ＝１３）和成石组豚鼠（ｎ＝９）胆汁胆固醇 浓度明显高于对照组（ｎ＝８）,分别为：０．５０ｍｍｏｌ／Ｌ±０．０９ｍｍｏｌ／Ｌ比０．３９ｍｍｏｌ／Ｌ±０．１１ｍｍｏｌ／Ｌ,Ｐ＝０．０３;０．５０ｍｍｏｌ／Ｌ ±０．１０ｍｍｏｌ/     

进展期胃癌患者脾脏的细胞免疫状态

本文检测了进展期胃癌患者（ｎ＝１６）脾静脉血淋巴细胞（ＳＶＬ）和脾细胞（ＳＣ）的自然杀伤细胞（ＮＫ）、淋巴因子激活的杀伤细胞（ＬＡＫ）的杀伤活性及Ｔ细胞（ＴＣ）亚群，与胃良性病变（ｎ＝７）的ＳＶＬ及外伤性脾破裂（ｎ＝６）的ＳＣ对照比较，探讨进展期胃癌（ＡＧＣ）患者脾脏的细胞免疫状态，为胃癌术中合理的处理脾脏提供免疫学依据。结果表明：ＡＧＣ患者脾脏的ＮＫ、ＬＡＫ细胞杀伤活性显著降低（Ｐ＜０．０２，Ｐ＜０．０１）；ＣＤ４显著减少，ＣＤ８显著增加，ＣＤ４／ＣＤ８比值显著降低（Ｐ＜０．０２～０．０１）。提示进展期胃癌患者脾脏的细胞免疫功能受到明显抑制。     

胆源性胰腺炎的手术时机探讨

目的探讨轻型急性胆源性胰腺炎的手术时机。方法回顾性分析我院2002年2月-2007年12月收治的49例胆源性胰腺炎的临床资料。将49例按入院后的手术时间分为早期手术组（A组）和延期手术组（B组）。结果早期手术组较延期手术组并发症发生率高;两组病死率无差别。早期手术和延期手术胆总管探查率分别为95．2％和39．3％,胆总管探查阳性率分别为45．0%和90．9％。结论早期手术和延期手术均是安全的。最佳手术时机是炎症发作消退、血清淀粉酶降至正常后首次住院期内。     

Timing of laparoscopic cholecystectomy for acute cholecystitis: evidence to support a proposal for an early interval surgery

We evaluated the safety and feasibility of delayed urgent laparoscopic cholecystectomy (LC) performed beyond 72 hours to overcome the logistical difficulties in performing early urgent LC within 72 hours of admission with acute cholecystitis (AC), and to avoid earlier readmission with recurrent AC in patients awaiting delayed interval. Patients admitted with AC were scheduled for urgent LC. Patients who underwent early urgent LC were compared with those who had delayed urgent surgery. Fifty consecutive patients underwent urgent LC for AC within 2 weeks of admission. There were no conversions and no bile duct injuries. Delayed surgery (n=36) neither prolonged operating time (90 vs. 85 minutes), nor increased operative morbidity (9.7% vs. 7.7%) or mortality (2.4% vs. 7.7%) compared with early surgery (n=14). Although delayed surgery was associated with shorter postoperative hospital stay (1 vs. 2 days, P = 0.029), it prolonged total hospital stay (9 vs. 5 days, P < 0.0001). Delay of LC beyond 72 hours neither increases operative difficulty nor prolongs recovery. It might be more cost effective to schedule patients who could not undergo early urgent LC but are responding to conservative treatment for an early interval LC within 2 weeks of presentation with AC.     

��ǻ���ڼ��Ե�Դ�������������е�Ӧ��

目的：探讨应用腹腔镜技术治疗急性胆源性胰腺炎的可行性、有效性和手术方法。方法：1996～2002年收治急性胆源性胰腺炎39例，对20例有急性胆道梗阻者，行急诊或早期腹腔镜胆囊切除术．胆总管切开取石T管引流、小网膜囊腔胰腺区清创引流，术后予腹腔灌洗。对19例无胆道梗阻或经36h保守治疗胆道梗阻缓解者，待胰腺炎缓解后行延期腹腔镜确定性胆道手术。结果：急诊或早期手术的20例，18例胆总管结石取石顺利，2例探查阴性。延期手术19例，腹腔镜手术均予术中胆道造影。5例合并胆总管结石者行腹腔镜胆总管切开取石T管引流。14例胆囊结石行腹腔镜胆囊切除术(LC)。39例均治愈。结论：腹腔镜手术治疗急性胆源性胰腺炎，体现了微创手术的优点，可在一定程度上替代外科剖腹手术治疗。     

A 10-year experience with the use of laparoscopic cholecystectomy for acute cholecystitis: is it safe?

BACKGROUND: In the era of open surgery, emergency open cholecystectomy has been shown for many reasons to be preferred to delayed surgery for acute cholecystitis. Despite the fact that elective laparoscopic cholecystectomy (LC) has become the gold standard for the treatment of symptomatic gallstone disease, the same procedure remains controversial for the management of acute cholecystitis because it is considered to be associated with more complications and an increased risk of common bile duct injuries than interval LC after resolution of the acute episode. The purpose of this report is to describe our experience with LC for acute cholecystitis during a 10-year period. METHODS: Patients undergoing laparoscopic surgery have been entered prospectively into a database since 1995. Those who underwent surgery before 1995 were added retrospectively to the same database. Patients were included in this study if they underwent emergency laparoscopic cholecystectomy for suspected acute cholecystitis. The diagnosis was based on clinical, laboratory, and echographic examinations. Analysis was performed to identify risk factors associated with conversion or morbidity. RESULTS: Of the 1,212 patients subjected to LC between 1990 and 1999, 268 (151 women and 117 men), with a mean age of 53 years, underwent surgery on an emergency basis for suspected acute cholecystitis. Their mean age (p = 0.002) and the proportion of men (p < 0.001) were higher than in the elective group. Delay before admission and surgery varied widely, but 72% of the patients underwent surgery within 48 h of admission. An intraoperative cholangiography, attempted in 218 patients, was successful in 207 (95%). Histologic examination confirmed acute cholecystitis in 82% of the patients. Conversion was necessary in 15.6% of the cases. It occurred more frequently in patients who underwent surgery later than 48 (p = 0.03) or 96 h (p = 0.006) after admission. No other predictor of conversion was found. Overall morbidity was 15.3%, and major morbidity was 4.4%. The only risk factor for morbidity was a bilirubin level greater than 20 mmol/l (p = 0.02). Three partial lesions of the common bile duct occurred. All were recognised and repaired immediately with no adverse effect. There was no difference in the overall rate of biliary complications between the patients operated for acute cholecystitis and those who underwent elective surgery. No reoperation was necessary, and there was no mortality. CONCLUSIONS: Although LC is safe and effective for acute cholecystitis, its associated morbidity and conversion rate are higher than for elective LC. The conversion rate decreases with experience. When surgery is performed within 2 or maximally 4 days of admission, in experienced hands, LC represents the treatment of choice for acute cholecystitis. Intraoperative cholangiography should be performed in every case because it helps to clarify the anatomy and allows for early diagnosis and repair of bile duct injuries.     

腹腔镜胆总管探查术治疗胆总管结石合并胆囊结石

目的 探讨腹腔镜胆总管探查术( LC BDE)治疗胆总管结石合并胆囊结石的临床疗效和价值.方法 2006年7月至2010年6月期间对127例胆总管结石合并胆囊结石患者进行微创治疗.其中78例采用LCBDE+腹腔镜胆囊切除术(LC)治疗,49例采用内镜十二指肠括约肌切开术(EST) +LC治疗.比较二组的手术治疗成功率、术后并发症发生率、残余结石率、胃肠功能恢复时间、住院时间和费用等指标,并随访二组远期并发症发生率.结果 LCBDE+ LC组:手术成功率94.87％,术后并发症发生率5.41％.EST+LC组:手术成功率95.92％,术后并发症发生率12.77％.两组手术成功率差异无统计学意义(P＞0.05),术后并发症发生率差异有统计学意义(P＜0.05).手术时间、住院费用的比较差异有统计学意义(P＜0.05).出院后随访1～5年,平均(3.2±0.8)年,LCBDE+LC组结石复发率、胆管积气发生率、反流性胆管炎发生率显著低于EST+LC组(P＜0.05).结论 LCBDE+LC是治疗胆囊结石合并胆总管结石的安全、有效、可行的微创术式,对于适宜的患者行胆总管一期缝合更能体现微创的优势.     

急性胆囊炎“延期”腹腔镜胆囊切除的手术技巧及并发症预防

目的 探讨急性胆囊炎延期腹腔镜胆囊切除术(LC)的手术技巧及并发症预防.方法 将2004年2月至2008年8月收治的133例急性胆囊炎行LC患者,按急性胆囊炎发作后手术治疗的时间分为两组:急性发作72 h内手术的为早期组(34例)和急性发作72 h后手术的延期组(99例).手术技巧是沿胆囊壶腹分离胆囊管,尽量充分“掏空”、显露Calot三角,顺行切除胆囊;如Calot三角粘连紧密,解剖关系不清,可逆性切除胆囊或自壶腹部行胆囊大部切除术.延期组手术难度增大主要集中在Calot三角的处理上.结果 133例全部完成LC手术,无中转开腹,无胆道损伤及胆漏等并发症,无术后30 d再入院.顺行切除术127例,逆行切除术2例,胆囊大部切除术4例.延期组较早期组LC手术时间延长[(44.1±5.32)min比(66.4±3.05) min,P＜0.01];两组切口感染率比较差异无统计学意义(2.94％比2.02％,P＞0.05).结论 延期LC较早期LC难度增大,但同样安全可行;把握好LC的手术技巧和熟练的技术是预防并发症的关键所在.     

急性胆源性胰腺炎167例外科治疗分析

目的　探讨急性胆源性胰腺炎 (AGP)的合理诊治方法。方法　回顾分析 167例AGP资料并将其分为重型组 ( 4 9例 )和轻型组 ( 118例 ) ,分析胆道梗阻情况、外科手术时机及术后并发症对死亡率的影响。结果　入院时有否梗阻病死率无差别 (P >0 .0 5 ) ,梗阻时间 >48h者病死率高于 <48h者 ( P <0 .0 5 ) ;重症AGP早期手术死亡率高于延期手术 ( P <0 .0 5 ) ;轻症AGP早晚期手术间病死率无统计学差异 (P >0 .0 5 ) ;术后胰腺感染和MODS是AGP的主要死因。结论　入院时壶腹部梗阻不是AGP手术指征 ,若梗阻持续不能解除 ( >48h)则考虑手术 ;重症AGP慎行早期手术 ;预防并及时处理并发症是降低AGP病死率的关键。     

Prospective randomized study of early versus delayed laparoscopic cholecystectomy for acute cholecystitis.

OBJECTIVE: A prospective randomized study was undertaken to compare early with delayed laparoscopic cholecystectomy for acute cholecystitis. SUMMARY BACKGROUND DATA: Laparoscopic cholecystectomy for acute cholecystitis is associated with high complication and conversion rates. It is not known whether there is a role for initial conservative treatment followed by interval elective operation. METHOD: During a 26-month period, 99 patients with a clinical diagnosis of acute cholecystitis were randomly assigned to early laparoscopic cholecystectomy within 72 hours of admission (early group, n = 49) or delayed interval surgery after initial medical treatment (delayed group, n = 50). Thirteen patients (four in the early group and nine in the delayed group) were excluded because of refusal of operation (n = 6), misdiagnosis (n = 5), contraindication for surgery (n = 1), or loss to follow-up (n = 1). RESULTS: Eight of 41 patients in the delayed group underwent urgent operation at a median of 63 hours (range, 32 to 140 hours) after admission because of spreading peritonitis (n = 3) and persistent fever (n = 5). Although the delayed group required less frequent modifications in operative technique and a shorter operative time, there was a tendency toward a higher conversion rate (23% vs. 11%; p = 0.174) and complication rate (29% vs. 13%; p = 0.07). For 38 patients with symptoms exceeding 72 hours before admission, the conversion rate remained high after delayed surgery (30% vs. 17%; p = 0.454). In addition, delayed laparoscopic cholecystectomy prolonged the total hospital stay (11 days vs. 6 days; p < 0.001) and recuperation period (19 days vs. 12 days; p < 0.001). CONCLUSIONS: Initial conservative treatment followed by delayed interval surgery cannot reduce the morbidity and conversion rate of laparoscopic cholecystectomy for acute cholecystitis. Early operation within 72 hours of admission has both medical and socioeconomic benefits and is the preferred approach for patients managed by surgeons with adequate experience in laparoscopic cholecystectomy.     

腹腔镜胆囊切除术后迟发性胆漏的临床分析

目的:探讨腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)术后迟发性胆漏的发生原因及处理措施。方法:回顾分析LC术后10例迟发性胆漏患者的临床资料。结果:迷走胆管漏6例,均行腹腔镜探查术,于胆囊床迷走胆管上WECK夹,并缝扎,经通畅引流治愈。2例胆总管侧壁漏行胆总管修补加"T"管引流治愈。2例胆囊管撕裂致残端漏经腹腔镜探查腹腔引流,行内镜逆行胰胆管造影术(endoscopic retrograde cholangiopancreatography,ERCP)和内镜鼻胆管引流(endoscopic naso-biliary drainage,ENBD)治愈。结论:LC术后迟发性胆漏有特定的发生原因,是可以减少或避免的。建立通畅的腹腔引流和胆管引流或行腹腔镜探查结合ERCP+ENBD是治疗LC术后迟发性胆漏的可行方法。     

早期腹腔镜胆囊切除术治疗老年轻症急性胆源性胰腺炎

目的探讨老年轻症急性胆源性胰腺炎(ABP)行腹腔镜胆囊切除术(LC)的安全性和手术时机。方法对解放军413医院2008年1月至2016年6月收治的老年轻症ABP伴胆囊结石76例进行回顾性分析,患者被分成两组:早期手术组(发病48h内行LC)49例和择期手术组(发病2w~4w内行LC)27例。观察两组血清胆红素、血淀粉酶、丙氨酰氨基转移酶、天门冬氨酸氨基转移酶变化,手术相关资料和总住院时间。结果术后第3天血清胆红素和血淀粉酶差异有统计学意义(t=7.766,t=11.49,P0.05),丙氨酰氨基转移酶和天门冬氨酸氨基转移酶差异无统计学意义(t=1.670,t=1.064,P0.05)。两组总住院时间差异有统计学意义(t=4.300,P0.05),手术时间、中转开腹率和切口感染发生率差异无统计学意义(t=1.544,χ~2=0.204,χ~2=0.007,P0.05)。结论早期和择期LC治疗老年轻症ABP疗效和风险无明显差异,从治疗的彻底性出发,在患者身体状态条件允许的情况下可优先选择早期LC术。