摘要
为评价急诊腹腔镜胆囊切除术（ＬＣ）治疗急性梗阻化脓性或坏疽性胆囊炎的安全性和有效性，统计了３５７例急诊ＬＣ和１６４３例择期ＬＣ的多项指标。结果表明，急诊组和择期组平均手术时间分别为５４．８２±３３．２１和３２．１７±１９．１６分钟（Ｐ＜０．０５）；中转开腹手术率分别为９．５２％和１．１３％（Ｐ＜０．０１）；腹腔引流率为２６．２１％和６．８１％；估计失血量为８６．７０±４０．２４和２９．５０±２６．９２ｍｌ；住院时间急诊组长于择期组。作者认为，对于复杂和困难的急诊组ＬＣ治疗，上述结果都是可以接受的。急诊组的９０．４８％和择期组９８．８７％的患者能够采用ＬＣ治愈。随着发病到就诊时间的延长（＞７２小时），急诊组ＬＣ难度增加，手术时间延长，中转开腹手术率明显升高（＞２０％）。这些提示，发病到就诊时间是影响ＬＣ成功率的一个非常重要的因素。
The records of laparoscopic cholecystectomy (LC) performed on acute cases (357) and elective patients (1 643) were analysed to compare the efficacy and safety of urgent LC.Results showed that (1)selective and urgent operation lasted 3217±1916 and 5482±3321 minutes respectively (P<005);(2)rate of switch to open surgery increased from 113%(selective LC) to 952%(urgent LC)(P<001);(3)blood loss augmented from 2950±2692 to 8670±4024ml;(4)percentage of abdominal drain were 681 and 2621 accordingly;(5)hospitalization of urgent LC was statistically longer(P<005).The anthors considered that (1)for complicate emergent cases,the results were acceptable;(2)9048% of acute cholecystitis could be cured with urgent LC;(3) the period from initiation of illness to LC appeared critical to perform the procedure as the difficulty increased with prolongation of time.
出处
《中华消化内镜杂志》
1998年第2期69-71,共3页
Chinese Journal of Digestive Endoscopy
关键词
腹腔镜
胆囊切除术
安全性
有效性
Acute suppurative cholecystitis Laparoscopic cholecystectomy
