腹腔镜逆行胆囊切除术和次全胆囊切除术治疗复杂性胆囊结石疗效比较

目的比较腹腔镜逆行胆囊切除术与次全胆囊切除术治疗复杂性胆囊结石的效果。方法选择复杂性胆囊结石患者75例,分别行腹腔镜逆行胆囊切除术(A组,37例)与次全胆囊切除术(B组,38例);比较2组患者手术指标及术后康复情况。结果 B组患者手术时间(86.47±17.95)min、术中出血量(82.58±34.84)mL、术中补液量(786.57±128.65)mL显著低于A组的(103.72±22.56)min、(108.23±41.46)mL和(975.68±151.36)mL,差异均有统计学意义(P<0.05);2组患者中转开腹率、术后体温、腹腔引流量、术后通气时间及住院时间比较差异均无统计学意义(P>0.05)。2组患者均无明显并发症发生。结论腹腔镜逆行胆囊切除术与次全胆囊切除术疗效相当,但后者操作简便,手术时间短,对于耐受性差的患者更为适合。

A comparative study on laparoscopic retrograde cholecystectomy and subtotal cholecystectomy in treatment of patients with complicated gallstone

Objective To compare the therapeutic effect of laparoscopic retrograde cholecystectomy and subtotal chole- cystectomy in the treatment of patients with complicated gallstone. Methods Seventy-five patients with complicated gallstone were selected and divided into group A and B. Patients in group A（ n ：= 37 ）underwent laparoscopic retrograde cholecystecto- my,and patients in group B（n =38） underwent laparoscopic subtotal cholecystectomy. The operation-related indexes and post- operative recovery condition of patients in the two groups were compared. Results The operation time, intraoperative blood loss and volume of fluid infusion of patients in group B were （86.47 ±17.95） rain, （82.58 ±34.84） mL and （786.57 ±128.65 ） mL respeetiyely, which in group A were （ 103.72 ±22.56 ） min, （ 108.23 ±41.46 ） mL and （ 975.68 ± 151.36 ） mL re- speetively;the operation time, intraoperative blood loss and volume of fluid infusion of patients in group B were significantly less than those in group A（ P 〈 0.05 ）. There was no significant differenee in conversion rate of open surgery, body temperature on the first and the second day after operation, peritoneal drainage volume, postoperative ventilation time and hospital stay time between the two groups（ P 〉0. 05 ）. No obviously complications occurred in the two groups. Conclusions The laparoscopic retrograde cholecystectomy and subtotal cholecystectomy have a similar therapeutic effectiveness. But laparoscopic subtotal cholecystectomy is easier operation, shorter operative time and less blood loss, so it is more appropriate for patients with poor tolerance.