糖尿病患者行腹腔镜及开腹胆囊切除术81例报告

目的探讨外科治疗胆囊结石合并糖尿病的手术方式和时机的选择。方法回顾分析手术治疗胆囊结石合并糖尿病81例临床资料，其中腹腔镜胆囊切除术（LC）组41例，开腹胆囊切除术（OC）组40例。比较两组手术时间、术中出血量、住院时间、并发症发生率及围手术期血糖变化。结果LC与OC组相比，术中出血量少、手术时间短、术后住院时间少，两组比较差异有统计学意义。LC组总并发症发生率明显低于开腹组（P〈0．05），其中切口并发症发生率低于OC组（P〈0．05）。LC组术中血糖明显低于OC组，但术前和术后血糖的变化，差异无统计学意义。结论腹腔镜胆囊切除术具有创伤小、恢复快、并发症少等优点，用于治疗胆囊结石合并糖尿病可行，且安全有效。急性结石性胆囊炎合并糖尿病患者应尽量早期手术治疗。

Retrospective study of 81 cholecystolithiasis patients with diabetes mellitus treated by laparoscopic versus open cholecystotomy

Objective To investigate the timing and the appropriate method of surgical treatment in cholecystolithiasis patients with diabetes mellitus. Methods The clinical data of 81 cholecystolithiasis patients with diabetes mellitus were retrospectively analyzed. Among the patients ,41 were subjected to laparoseopic cholecystectomy （ LC）, and 40 were subjected to open cholecystectomy （ OC ）. The operative duration,blood loss ,length of hospital stay, operative complications and perioperative blood glucose level were compared between patients receiving LC and OC. Results In LC group, the operative duration was shorter, the blood loss was less, the length of hospital stay was shorter and the operative complications were fewer than the OC group （ P 〈 0.05 ）. The intraoperative blood glucose level of LC group was significantly lower than the OC group, but the preoperative and postoperative blood glucose level were not significantly different. Conclusion Based on the less trauma, quicker recovery and fewer complications,LC is safe and feasible in cholecystolithiasis patients with diabetes mellitus. Furthermore ,gallbladder infection in diabetes mellitus requires an operation as soon as possible.