腹腔镜与小切口胆囊切除术治疗急性胆囊炎的临床效果比较

目的比较腹腔镜胆囊切除术（LC）与小切口胆囊切除术（MC）治疗急性胆囊炎的临床效果。方法回顾性分析228例行胆囊切除术的急性胆囊炎患者的临床资料,包括LC 152例,MC 76例。对两组的手术时间、术中出血量、术后住院时间、住院总费用、并发症等指标进行对比分析。结果 LC组的手术时间平均（69.2±20.1）min,较MC组（82.4±12.7）min短;术中出血量平均（37.9±16.3）ml,较MC组（45.4±22.1）ml少;术后住院时间平均（4.8±1.7）d,较MC组（7.3±2.9）d短;住院总费用平均（4722.0±554.9）元,较MC组（4140.1±416.4）元高;差异均具有统计学意义（P〈0.05）。LC组术后并发感染率9.2%（14/152）,其中伤口感染6.6%（10/152）,肺部感染2.6%（4/152）;MC组术后并发感染率21.1%（16/76）,其中伤口感染14.5%（11/76）,肺部感染6.6%（5/76）;两组差异具有统计学意义（P〈0.05）。两组均未发现胆管损伤、胆漏、胆囊残株炎等并发症。结论 LC、MC治疗急性胆囊炎均有效,与MC比较,LC手术时间短、术中出血量少、术后住院时间短、术后并发感染率低,但住院总费用较高,可作为治疗急性胆囊炎的手术方式的优先选择。

Clinical efficacy comparison of laparoscopic cholecystectomy and small incision cholecystectomy in patients with a cute cholecytitis

Objective To compare the clinical efficacy of laparoscopic cholecystectomy（LC） and small incision cholecystectomy（MC） in patients with acute cholecytitis.Methods Clinical data of 228 cases with acute cholecytitis operated by cholecystectomy were analyzed retrospectively.Among them,152 cases received LC and 76 cases received MC.Operative time,intraoperative blood loss,postoperative hospital stay,hospitalization cost,and complications were compared between the two groups.Results The Operative time was shorter in LC group,which was（69.2±20.1）min,than that in MC group,which was（82.4±12.7）min.The intraoperative blood loss in LC group was less than that in MC group,which were（37.9±16.3）ml and（45.4±22.1）ml,respectively.The postoperative hospital stays were（4.8±1.7） d and（7.3±2.9） d in LC group and MC group,and the hospitalization cost were（4722.0±554.9） Yuan and（4140.1±416.4） Yuan in LC group and MC group.All differences were statistically significant（P0.05）.The postoperative infection rate in LC group and MC group were 9.2%（14/152） and 21.1%（16/76）,respectively,among them wound infections accounted for 6.6%（10/152） and 14.5%（11/76）,respectively,and lung infections accounted for 2.6%（4/152） and 6.6%（5/76）,respectively（P0.05）.No bile duct injury,bile leakage,and gallbladder stumps inflammation were observed in both groups.Conclusion LC and MC were both effective in acute cholecytitis.Compared with MC,LC showed shorter operative time,less intraoperative blood loss,shorter postoperative hospital stay,lower postoperative infection rate and higher hospitalization cost,and LC could be the priority selection for acute cholecytitis.