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[急性胆囊炎的早期腹腔镜胆囊切除术]

[Early laparoscopic cholecystectomy for acute cholecystitis].

作者信息

Tekin Ahmet, Küçükkartallar Tevfik, Belviranli Metin, Vatansev Celalettin, Aksoy Faruk, Tekin Sakir, Kartal Adil

机构信息

Department of General Surgery, Selçuk University Meram Faculty of Medicine, Konya, Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2009 Jan;15(1):62-6.

Abstract

BACKGROUND

The aim of this study was to assess the clinical results of treatment by laparoscopic cholecystectomy (LC) in patients with acute cholecystitis.

METHODS

Between 1994 and 2006, LC was performed in 3876 patients in Selcuk University Meram Medicine Faculty. The clinical, biochemical, radiologic, and operative data of 182 (101 F, 81 M) consecutive patients with acute cholecystitis operated 3 days after the onset of symptoms were analyzed retrospectively to determine the complications and morbidity after operation.

RESULTS

The conversion rate was 31 (17.03%) in acute cholecystitis. Postoperative length of stay was found as 4 days in the successful LC group and 7 days in the conversion group. For acute cholecystitis, we found a statistical difference between the successful LC group and the conversion group in terms of length of postoperative hospitalization time and gallbladder wall thickness. We identified the following factors as associated with conversion: male gender, pericholecystic collection seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm.

CONCLUSION

LC is a safe approach in selected patients with acute cholecystitis. Male gender, pericholecystic collection seen on ultrasound, gangrenous cholecystitis, and gallbladder wall thickness >1 cm are associated with a higher risk of conversion to open surgery.

摘要

背景

本研究旨在评估腹腔镜胆囊切除术(LC)治疗急性胆囊炎患者的临床效果。

方法

1994年至2006年间,塞尔丘克大学梅拉姆医学院对3876例患者实施了LC。回顾性分析了182例(101例女性,81例男性)症状发作3天后接受手术的急性胆囊炎连续患者的临床、生化、放射学和手术数据,以确定术后并发症和发病率。

结果

急性胆囊炎患者中转开腹率为31例(17.03%)。成功实施LC组术后住院时间为4天,中转开腹组为7天。对于急性胆囊炎,成功实施LC组与中转开腹组在术后住院时间和胆囊壁厚度方面存在统计学差异。我们确定以下因素与中转开腹相关:男性、超声显示胆囊周围积液、坏疽性胆囊炎以及胆囊壁厚度>1 cm。

结论

对于选定的急性胆囊炎患者,LC是一种安全的治疗方法。男性、超声显示胆囊周围积液、坏疽性胆囊炎以及胆囊壁厚度>1 cm与中转开腹手术的较高风险相关。

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