肝硬化并胆囊结石行腹腔镜手术与开腹胆囊切除术的疗效比较

目的比较腹腔镜胆囊切除术（LC）与剖腹胆囊切除术（OC）在合并肝硬化的胆囊结石症治疗中的效果。方法回顾性分析我院2001年1月-2007年6月收治的72例合并肝硬化的胆囊结石症手术病人的临床资料。其中，LC组38例，0t2组34例。观察两组病人的手术时间、术中出血量、手术并发症发生率和住院时间的资料，并进行统计学分析。结果LC组的手术时间、术中出血量、住院时间分别为（51．7±12．7）min、（98．6±25．5）ml、（6．2±2．9）d，OC组分别为（75．7±23．8）min、（134．6±36．6）ml、（9．2±3．7）d，两组比较均有显著性差异（P〈0．05）；手术并发症发生率LC组较OC组低（P〈0．05）。结论对Child分级为A级和B级合并肝硬化的胆囊结石病人采用LC治疗是相对安全的，并具有手术时间短、出血量少、手术并发症发生率低等优点。

Comparative study on laparoscopic and open cholecystectomy in patients with cholecystolithiasis associated with liver cirrhosis

Objective To investigate the effectiveness of laparoscopic cholecystectomy(LC)vs open cholecystectomy(OC)in the treatment of cholecystolithiasis associated with liver cirrhosis.Methods The clinical data of 72 of cholecystolithiasis associated with liver cirrhosis who underwent cholecystectomy were retrospectively analyzed.These cases were divied into LC group(n=38)and OC group(n=34).Operative time,intraoperative blood loss,hospital stay and incidence of complications were compared.Results Operative time was shorter in LC group than in OC group.Intraoperative blood loss was less in LC group than in OC group.The hospital stay in group LC was shorter than in OC.Conclusion LC could be safely performed on cholecystolithiasis patients with liver cirrhosis(Child Pugh A or/and B degree).It has several benefits over OC,including less intraoperative blood loss,shorter operative time and fewer complications.