Fisher K S, Reddick E J, Olsen D O
Southern Illinois University School of Medicine, Department of Surgery, Springfield 62794-9230.
Surg Laparosc Endosc. 1991 Jun;1(2):77-81.
Recently laparoscopic cholecystectomy (LC) has become an accepted alternative to the traditional open cholecystectomy (OP). The purpose of this study was to compare laparoscopic cholecystectomy to open cholecystectomy with respect to four variables: (a) operative time, (b) length of hospital stay, (c) total hospital cost, and (d) morbidity and mortality rates. The most recent 200 LCs performed at HCA West Side Hospital were selected for comparison in the study. Demographic data, including age and sex were collected for all patients. The medical record for each patient was then reviewed to obtain the study variables. A control group of 200 patients undergoing elective open cholecystectomy over the same period was selected. Complications occurred in 12 patients (6.0%) in the LC group with one postoperative mortality. Nineteen patients (9.5%) suffered complications in the OC group with no operative mortality. The difference between the two groups was not statistically significant. The average length of operation (recorded in minutes) in the OC group was 87.79 (SD +/- 20.69) as compared to 103.78 (SD +/- 29.01) in the LC group. This difference proved to be slight, but significantly greater (p < 0.0001). The average length of stay (recorded in days) in the OC group was 4.43 (SD +/- 1.29) versus 1.13 (SD +/- .93) in the LC group. Again, the difference proved to be statistically significant (p < 0.0001). The corrected average total hospital charge from OC was $3,006 (SD +/- 755) versus $2,312 (SD +/- 484) for LC, a difference that was statistically significant (p < 0.0001). Laparoscopic cholecystectomy is a safe, effective, and cost-efficient alternative to open cholecystectomy.(ABSTRACT TRUNCATED AT 250 WORDS)
最近,腹腔镜胆囊切除术(LC)已成为传统开腹胆囊切除术(OP)公认的替代方法。本研究的目的是比较腹腔镜胆囊切除术和开腹胆囊切除术在四个变量方面的情况:(a)手术时间,(b)住院时间,(c)总住院费用,以及(d)发病率和死亡率。在HCA西区医院最近进行的200例腹腔镜胆囊切除术被选入本研究进行比较。收集了所有患者的人口统计学数据,包括年龄和性别。然后查阅每位患者的病历以获取研究变量。选取同期进行择期开腹胆囊切除术的200例患者作为对照组。LC组有12例患者(6.0%)发生并发症,1例术后死亡。OC组有19例患者(9.5%)出现并发症,无手术死亡。两组之间的差异无统计学意义。OC组的平均手术时长(以分钟记录)为87.79(标准差±20.69),而LC组为103.78(标准差±29.01)。这一差异虽轻微,但具有显著统计学意义(p < 0.0001)。OC组的平均住院天数(以天记录)为4.43(标准差±1.29),而LC组为1.13(标准差±0.93)。同样,这一差异具有统计学意义(p < 0.0001)。OC组经校正后的平均总住院费用为3006美元(标准差±755),而LC组为2312美元(标准差±484),差异具有统计学意义(p < 0.0001)。腹腔镜胆囊切除术是开腹胆囊切除术安全、有效且具有成本效益的替代方法。(摘要截选至250字)