急性胆囊炎行腹腔镜胆囊切除术的时机：一项前瞻性非随机研究
Timing of laparoscopic cholecystectomy for acute cholecystitis: a prospective non randomized study.
作者信息
Tzovaras George, Zacharoulis Dimitris, Liakou Paraskevi, Theodoropoulos Theodoros, Paroutoglou George, Hatzitheofilou Constantine
机构信息
Department of Surgery, University of Thessaly School of Medicine, University Hospital of Larissa, 19 Agorogianni A. Street, Larissa 41335, Greece.
出版信息
World J Gastroenterol. 2006 Sep 14;12(34):5528-31. doi: 10.3748/wjg.v12.i34.5528.
AIM
To study the timing of laparoscopic cholecystectomy for patients with acute cholecystitis.
METHODS
Between January 2002 and December 2005, all American Society of Anesthesiologists classification (ASA) I, II and III patients with acute cholecystitis were treated laparoscopically during the urgent (index) admission. The patients were divided into three groups according to the timing of surgery: (1) within the first 3 d, (2) between 4 and 7 d and (3) beyond 7 d from the onset of symptoms. The impact of timing on the conversion rate, morbidity and postoperative hospital stay was studied.
RESULTS
One hundred and twenty-nine patients underwent laparoscopic cholecystectomy for acute cholecystitis during the index admission. Thirty six were assigned to group 1, 58 to group 2, and 35 to group 3. The conversion rate and morbidity for the whole cohort of patients were 4.6% and 10.8%, respectively. There was no significant difference in the conversion rate, morbidity and postoperative hospital stay between the three groups.
CONCLUSION
Laparoscopic cholecystectomy for acute cholecystitis during the index admission is safe, regardless of the time elapsed from the onset of symptoms. This policy can result in an overall shorter hospitalization.
目的
研究急性胆囊炎患者行腹腔镜胆囊切除术的时机。
方法
2002年1月至2005年12月期间，所有美国麻醉医师协会（ASA）分级为I、II和III级的急性胆囊炎患者在急诊（首次）入院时接受腹腔镜治疗。根据手术时机将患者分为三组：（1）症状出现后3天内；（2）4至7天；（3）症状出现7天后。研究手术时机对中转开腹率、发病率和术后住院时间的影响。
结果
129例患者在首次入院时因急性胆囊炎接受了腹腔镜胆囊切除术。36例被分配到第1组，58例到第2组，35例到第3组。整个患者队列的中转开腹率和发病率分别为4.6%和10.8%。三组之间的中转开腹率、发病率和术后住院时间无显著差异。
结论
在首次入院时对急性胆囊炎患者行腹腔镜胆囊切除术是安全的，无论症状出现后经过的时间长短。该策略可使总体住院时间缩短。
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