Hosseini Seyed Nejat, Mousavinasab Seyed Nouraddin, Rahmanpoor Haleh
Department of Surgery, Shafieeh Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
J Coll Physicians Surg Pak. 2007 Jul;17(7):406-9.
To evaluate the role of Laparoscopic Cholecystectomy (LC) in Acute Cholecystitis (AC) and Chronic Cholecystitis (CC) in terms of hospital stay, operation time, reason and rate of conversion and complications.
Quasi experimental.
Shafieeh Hospital, Zanjan University of Medical Sciences, Zanjan, Iran. The study was carried out prospectively between October 2003 and September 2006.
Fifty patients with Acute Cholecystitis (AC) were admitted to the emergency and performed LC in the first 72 hours following admission labelled as Acute Laparoscopic Cholecystectomy (ALC). One hundred and forty-one patients with AC were admitted for chronic LC, labelled as Chronic Laparoscopic Cholecystectomy (CLC). Patients were excluded with bilirubin greater than 3.5 mg/dl, alkaline phosphates greater than 250 (UL), age >90 years, choledocholithiasis and biliary pancreatitis. Data were collected prospectively which included patients' demographics, medical history, presentation, operative and postoperative time. For the comparison of groups, chi-square analysis, the Student 't' test and Mann-Whitney U test were used. P-value less than 0.05 were considered statistically significant.
The median of hospital stay were 2 and 3 days in CLC and ALC respectively (P=0.0005). The median of post operative stay were 0.83 and 1 day in CLC and ALC respectively (P=0.0005). The mean of operation time were 39.9, 58.8 minutes in CLC and ALC respectively. Conversion occurred in 5 (3.6%) patients in CLC and in 7 (14%) patients in ALC groups. Major complications were observed in 5 patients (3.6%) in CLC and 2 patients (5.1%) in ALC. 63 (46.3%) patients in CLC, 11 (22%) patients in ALC were discharged less than 10 hours after surgery.
This study showed that statistical differences exist in hospital stay, operation time, reason and rate of conversion in two groups, but no such difference in major complications. Laparoscopy appears to be safe and good approach for emergency cholecystectomy in patients with acute cholecystitis.
从住院时间、手术时间、中转原因及比率和并发症方面评估腹腔镜胆囊切除术（LC）在急性胆囊炎（AC）和慢性胆囊炎（CC）中的作用。
准实验性研究。
伊朗赞詹医科大学沙菲医院。该研究于2003年10月至2006年9月前瞻性开展。
50例急性胆囊炎患者入住急诊，在入院后72小时内行LC，标记为急性腹腔镜胆囊切除术（ALC）。141例慢性胆囊炎患者行择期LC，标记为慢性腹腔镜胆囊切除术（CLC）。排除胆红素大于3.5mg/dl、碱性磷酸酶大于250（UL）、年龄>90岁、胆总管结石及胆源性胰腺炎患者。前瞻性收集数据，包括患者人口统计学资料、病史、临床表现、手术及术后时间。采用卡方分析、学生t检验和曼-惠特尼U检验进行组间比较。P值小于0.05被认为具有统计学意义。
CLC组和ALC组的中位住院时间分别为2天和3天（P = 0.0005）。CLC组和ALC组的中位术后住院时间分别为0.83天和1天（P = 0.0005）。CLC组和ALC组的平均手术时间分别为39.9分钟和58.8分钟。CLC组5例（3.6%）患者中转，ALC组7例（14%）患者中转。CLC组5例（3.6%）患者和ALC组2例（5.1%）患者出现主要并发症。CLC组63例（46.3%）患者、ALC组11例（22%）患者术后不到10小时出院。
本研究表明两组在住院时间、手术时间、中转原因及比率方面存在统计学差异，但在主要并发症方面无差异。腹腔镜检查似乎是急性胆囊炎患者急诊胆囊切除术的安全且良好的方法。
