微创胆囊切除与普通开腹胆囊切除比较分析

目的　比较腹腔镜、小切口及普通开腹胆囊切除术的创伤程度及优越性。　方法　随机选取 1995年 12月至 2 0 0 0年 8月间腹腔镜胆囊切除术 (LC) 72 6例 ,小切口胆囊切除术 (MC) 32 4例 ,普通开腹胆囊切除术 (COC) 6 5 7例。比较了三组病人的手术时间、术后镇痛剂用量、术后体温、肠功能、白细胞计数恢复时间、术后住院日、总住院日以及总费用、并发症发生率等指标 ;方差分析比较三组是否有差异。　结果　LC组术后恢复指标与MC、COC组相比均有明显差异 (P <0 .0 1) ,MC组恢复较COC组亦有明显差异 (P <0 .0 1)。　结论　LC手术创伤程度小 ,病人恢复最快 ,但受器械及腹腔镜手术医生水平限制 ,对病人有选择性 ;MC手术也可属于微创外科范畴 ,其创伤较COC小 ,病人恢复也较快 ,手术费用最低 ,也是一种安全有效的手术方法 ,但手术医师需具有相当经验 ,对病人的选择性较LC手术大 ;COC为传统手术方式 ,创伤较前两者大 ,但对于炎症剧烈、解剖不清、胆道需探查等情况 ,仍属首选。

Laparoscopic Cholecystectomy vs Conventional Open Cholecystectomy: A Retrospective Study

Objective To compare the degree of trauma after laparoscopic cholecystectomy (LC) with that after minilaparotomy cholecystectomy (MC) and conventional open cholecystectomy (COC). Methods From December,1995 to August, 2000,726 cases of LC,324 cases of MC and 657 cases of COC were studied. Using the statistic method of ANOVA,we compared the indicators such as the duration of operation,post operative days,hospital stay days,total hospital costs,consumption of analgesic,post operative recovery time of bowel functions,temperature, WBC counts, and the rate of post operative complications. Results The indicators of post operative recovery after LC were significantly better than those after MC or COC( P <0.01), and those indicators after MC were also beyond those after COC ( P <0.01). Conclusion Although refrained with the operation instruments and the experience of the operators,LC is characterized by the least trauma and the quickest recovery. If the operators are highly skillful and choose patients carefully,MC is certainly a safe and economical operation method.As a raditional operation, COC is of choise in such situations as messy anatomy or unavoidable choledochotomy.