腹腔镜逆行及次全胆囊切除术治疗复杂胆囊患者的对比研究

目的:对比腹腔镜逆行与次全胆囊切除术治疗复杂胆囊患者的临床效果。方法:2010年3月至2012年7月为85例复杂胆囊患者行腹腔镜手术,按随机对照原则分为A组(n=43)与B组(n=42),A组行腹腔镜逆行胆囊切除术,B组行腹腔镜胆囊次全切除术。对比分析两组患者手术相关指标及术后康复情况。结果:两组患者中转开腹率、术后通气时间、腹腔引流管引流量、住院时间及术后第1天、第2天体温等方面差异无统计学意义(P>0.05),B组手术时间、术中出血量、术中补液量显著低于A组(P<0.05),两组均无明显并发症发生。结论:腹腔镜逆行与次全胆囊切除术治疗复杂胆囊患者均是安全、有效的,但腹腔镜次全胆囊切除术操作更简便,可有效缩短手术时间,减少术中出血,值得推荐。

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

Objective： To compare the therapeutic effects of laparoscopic retrograde cholecystectomy and subtotal cholecystectomy in the treatment of patients with complicated cholecyst.Methods： From Mar.2010 to Jul.2012,85 patients with complicated cholecyst were randomly assigned to two groups.Patients in group A（n = 43） underwent laparoscopic retrograde cholecystectomy,and patients in group B（n = 42） underwent laparoscopic subtotal cholecystectomy.The operation-related indexes and postoperative recovery condition of patients in two groups were comparatively studied.Results： There was no significant difference in the aspects of conversion rate to open surgery,postoperative ventilation time,peritoneal drainage volume,hospital stay and body temperature on the 1st and 2nd day after operation（P 0.05）.The operation time,intraoperative blood loss and volume of fluid infusion of patients in group B were all markedly less than those in group A（P 0.05）.No conspicuous complications occurred in either group.Conclusions： Both laparoscopic retrograde cholecystectomy and subtotal cholecystectomy are safe and effective for patients with complicated cholecyst,however,laparoscopic subtotal cholecystectomy is recommended for easier operation,shorter operative time and less blood loss.