兰州地区胆石症2180例诊治分析

目的了解兰州地区胆石症的发病特点。方法回顾分析2011年3月-2012年3月就诊的2180例胆石症患者临床资料。结果保守治疗335例,手术治疗1845例,治愈1844例。女性发病率高于男性,胆囊息肉与胆囊结石发病不相关。腹腔镜胆囊切除术1446例,其中常规腹腔镜胆囊切除术1371例;开腹胆囊切除399例。经统计分析,腹腔镜胆囊切除术手术时间、术中出血量、住院时间、术后胆瘘发生率均低于开腹胆囊切除术（P〈0.05）;其余各项均无统计学意义（P〉0.05）。结论兰州地区患胆石症人群在性别、年龄及饮食关系等方面有地区特点,且腹腔镜胆囊切除术在手术时间、术中出血量、住院时间及术后并发症等方面低于开腹胆囊切除术。

Clinical analysis of 2180 cases of cholelithiasis in Lanzhou

Objective To investigate the characteristics,management,and outcome of cholelithiasis patients treated in the Lanzhou region of China.Methods The clinical data of 2180 cases of cholelithiasis treated between March 2011 and March 2012 were retrospectively collected from the electronic medical records.The significance of differences between each of the features was analyzed by t-test or Chi-squared test.Results Surgical intervention was used to treat 84.6%（n=1845） of the cases,of which 1844 cases were cured and one died.The remaining 15.4%（n=335） of cases received conservative（non-surgical） treatments.Morbidity was higher among women than men（1187/993）.Incidence of gallbladder polyps was not correlated with gallstone presence.Laparoscopic cholecystectomy was performed in 1446 cases,and included 1371 cases of laparoscopic cholecystectomy and 399 cases of open cholecystectomy.Both the time and amount of intraoperative bleeding,as well as the time to complete the cholecystectomy,were significantly lower for the laparoscopic procedure than the open procedure（P0.05）.The laparoscopic procedure had a significantly lower incidence of postoperative biliary fistula（vs.open cholecystectomy,P0.05）,but no other complications were significantly different between the two groups.When the overall cases were stratified according to geographical regions of the Lanzhou area,differences were observed in the incidences among females to males,age groups,and dietary practices.Conclusion Compared to open cholecystectomy,laparoscopic cholecystectomy is safer,since it requires a shorter operative time,produces less intraoperative bleeding,and is associated with less postoperative biliary fistula.The etiologies of cholelithiasis vary by geographic region and may help to develop effective targeted preventive strategies.