急性结石性胆囊炎手术时机的选择

目的探讨急性结石性胆囊炎的手术时机的选择。方法120例急性结石性胆囊炎分为急诊手术组（组Ⅰ，n=40）、延期手术组（组Ⅱ，n=40）、择期手术组（组Ⅲ，n=40），对并发症，治疗结果进行统计学分析。结果急诊手术组和择期手术组的术后并发症发生率均低于延期手术组，择期手术组治愈率高，（P〈0．05），且LC术式明显高于前两组（P〈0．05），LC术式成功率显著高于前两组。结论急性结石性胆囊炎急诊早期手术和择期手术优于延期。急性胆囊炎发病后72h内均可进行安全的胆囊切除手术。病程超过一周者宜采取保守治疗，6～8周后行择期手术。

Timing of cholecystectomy for acute gallstone cholecystitis

Aim To discuss the appropriate time of cholecystectomy for acute gallstone cholecystitis. Methods 120 cases of acute gallstone eholecystitis were divided into 3 groups, emergency cholecystectomy group （Ⅰ） ,40 patients, early surgery undertaken within 72 hours following the onset of acute gallstone choleeystitis;delayed cholecysteetomy group（ Ⅱ ） ,40 cases,intervention within 7 days to 2 weeks, and selective cholecysteetomy group（ Ⅲ） ,40 cases, surgery done within one month to two months. Statistic analysis was made in terms of incidences of postoperative complication and therapeutic result. Result The incidence of postoperative complication was significantly lower in group Ⅰ and Ⅲ. Therapeutic result was significantly better in group Ⅲ than in group Ⅰ and group Ⅱ （ P 〈 0.05 ）. The method of laparoscopic cholecystectomy used in group Ⅲ and the achievement ratio of laparoseopic choleeystectomy was significantly higher than in group Ⅰ and group Ⅱ （P 〈 0. 05）. Conclusion Emergency cholecystectomy and delayed cholecystectomy are superior for the patients of acute gallstone eholecystitis. Acute gallstone eholecystectomy can be safely undertaken in different intervals within 72 hours following the onset of acute gallstone cholecystitis. When the course of acute choleeystitis was over a week,drug therapy can be suggested.