贵州医科大学学报

2015, v.40;No.182(11) 1262-1264

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腹腔镜逆行次全胆囊切除术治疗急性胆囊炎
Research on Treatment of Acute Calculous Cholecystitis by Retrograde Laparoscopic Subtotal Cholecystectomy

袁兵;杨振德;秦军;
YUAN Bing;YANG Zhende;QIN Jun;Department of Hepatobiliary Surgery,People's Hospital of Shifang City;

摘要(Abstract):

目的:探讨腹腔镜逆行次全胆囊切除术治疗急性胆囊炎的临床疗效。方法:急性胆囊炎患者86例,根据腹腔镜逆行切除胆囊的方式分为全切组和次全切组;观察两组患者术中平均出血量、手术时间、住院时间及引流时间,检测患者术前、术后12、24及48 h的C反应蛋白(CRP)水平,观察两组患者术后感染、肠粘连、腹膜炎及胆汁漏出等术后并发症。结果:次全切组急性胆囊炎患者术中平均出血量、手术时间、住院时间及引流时间优于全切组患者(P<0.05);两组患者术前CRP水平比较P>0.05,次全切组术后12、24及48 h CRP水平高于全切组(P<0.05),CRP水平在术后24 h最高;全切组感染、肠粘连、腹膜炎及胆漏并发症的发生率(25.58%)均高于次全切组(9.30%,P=0.047)。结论:腹腔镜下逆行次全胆囊切除术治疗急性胆囊炎的临床效果优于全胆囊切除术。
Objective: To investigate the clinical efficacy of treating acute calculous cholecystitis by retrograde laparoscopic subtotal cholecystectomy. Methods: Eighty-six patients of acute calculous cholecystitis,divided into whole resection group and subtotal group; two groups were observed and compared the average operation time,average blood loss,drainage time,testing CRP level before surgery,12 h,24 h and 48 h after surgery. Observing complications such as postoperative infection,intestinal adhesions,peritonitis and bile leakage. Results: Average blood loss,operation time,hospitalization time,and drainage time of subtotal group were better than total resection group( P < 0. 05); CRP levels of subtotal group in 12 h,24 h and 48 h after surgery were higher than that of control group( P <0. 05),CRP level reached highest in 24 h after surgery; incidences of postoperative infection,intestinal adhesions,peritonitis and bile leakage of resection group( 25. 58%) were higher than subtotal group( 9. 30%,P = 0. 047). Conclusions: Treating acute calculous cholecystitis by retrograde laparoscopic subtotal cholecystectomy is more clinically effective than cholecystectomy.

关键词(KeyWords): 胆囊炎,急性;腹腔镜;逆行胆囊切除;胆囊次全切
cholecystitis,acute;laparoscopy;retrograde cholecystectomy;subtotal cholecystectomy

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作者(Author): 袁兵;杨振德;秦军;
YUAN Bing;YANG Zhende;QIN Jun;Department of Hepatobiliary Surgery,People's Hospital of Shifang City;

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DOI: 10.19367/j.cnki.1000-2707.2015.11.036

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