Leandros E, Kymionis G D, Konstadoulakis M M, Albanopoulos K, Dimitrakakis K, Gomatos I, Androulakis G
1st Department of Propedeutic Surgery, University of Athens, Greece.
Eur J Surg. 2000 Nov;166(11):859-61. doi: 10.1080/110241500447236.
To compare laparoscopic with open cholecystectomy in patients with sickle cell disease.
Retrospective clinical study.
University hospital, Greece.
41 patients (22 men and 19 women) with sickle cell disease had laparoscopic cholecystectomy between September 1991 and June 1998. Each patient was matched for age, sex, year of operation, and number of preoperative transfusions with control patients with sickle cell disease who had open cholecystectomy.
Duration of operation, postoperative stay in hospital, incidence of complications, and conversion to open operation.
The mean operation time was 81.4 min (range 55-125) for open cholecystectomy and 64.2 min (range 45-90) for laparoscopic cholecystectomy (p < 0.01). Complications occurred in 5% (2/41) of the patients in the laparoscopic group and in 20% (8/41) of the patients in the open group (p = 0.04). The mean length of stay in hospital was 5.6 days (range 3-9) in the open group and 2.7 days (range 2-5) in the laparoscopic group (p < 0.01). Conversion to open operation was necessary in 2 (5%) patients.
Laparoscopic cholecystectomy resulted in a shorter hospital stay with fewer postoperative complications than open operation in patients with sickle cell disease and may be the procedure of choice in the treatment of cholelithiasis in such patients.
比较镰状细胞病患者行腹腔镜胆囊切除术与开腹胆囊切除术的效果。
回顾性临床研究。
希腊大学医院。
1991年9月至1998年6月期间，41例（22例男性和19例女性）镰状细胞病患者接受了腹腔镜胆囊切除术。将每名患者与接受开腹胆囊切除术的镰状细胞病对照患者在年龄、性别、手术年份和术前输血次数方面进行匹配。
手术时间、术后住院时间、并发症发生率及转为开腹手术的情况。
开腹胆囊切除术的平均手术时间为81.4分钟（范围55 - 125分钟），腹腔镜胆囊切除术为64.2分钟（范围45 - 90分钟）（p < 0.01）。腹腔镜组5%（2/41）的患者发生并发症，开腹组为20%（8/41）的患者（p = 0.04）。开腹组的平均住院时间为5.6天（范围3 - 9天），腹腔镜组为2.7天（范围2 - 5天）（p < 0.01）。2例（5%）患者需要转为开腹手术。
对于镰状细胞病患者，腹腔镜胆囊切除术较开腹手术术后住院时间更短，并发症更少，可能是此类患者胆结石治疗的首选术式。
