Ancona E, Zaninotto G, Rossi M, Costantini M, Finco C, Bovolato M
Istituto di Semeiotica Chirurgica, Università di Padova, Italy.
Ital J Gastroenterol. 1992 Jul-Aug;24(6):320-3.
This study analyzes data from 100 consecutive patients with gallstone disease who underwent laparoscopic cholecystectomy (LC), a surgical technique rapidly emerging as the treatment of choice for this disease. LC has two major advantages: reduction of postoperative pain and a shortened hospital stay. LC was successfully completed in 88 patients, the main cause of conversion to open cholecystectomy being acute or chronic inflammation of the gallbladder. Analysis of risk factors showed that age, obesity, episodes of jaundice, pancreatitis, and acute or chronic cholecystitis are not absolute contraindications to LC. Mortality was absent and the intraoperative morbidity rate was 2%. No lesion of the main bile duct occurred. Seven minor post-operative complications that did not prolong hospital stay were also observed. These figures compare well with the mortality and morbidity of open cholecystectomy, and demonstrate that the significant benefits in terms of patient welfare and hospital costs of LC are not obtained at the expense of increased surgical risk.
本研究分析了100例连续接受腹腔镜胆囊切除术(LC)的胆结石病患者的数据,LC作为这种疾病的首选治疗方法,是一种迅速兴起的外科技术。LC有两个主要优点:减少术后疼痛和缩短住院时间。88例患者成功完成了LC,转为开腹胆囊切除术的主要原因是胆囊的急性或慢性炎症。危险因素分析表明,年龄、肥胖、黄疸发作、胰腺炎以及急性或慢性胆囊炎并非LC的绝对禁忌证。无死亡病例,术中发病率为2%。未发生主胆管损伤。还观察到7例未延长住院时间的轻微术后并发症。这些数据与开腹胆囊切除术的死亡率和发病率相比很有优势,表明LC在患者福利和医院成本方面的显著益处并非以增加手术风险为代价获得的。