Department of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, 3-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.
BMC Gastroenterol. 2012 Aug 21;12:113. doi: 10.1186/1471-230X-12-113.
We evaluated the safety and validity of cholecystomucoclasis (CM) and compared its intraoperative characteristics with those of standard cholecystectomy (SC).
We enrolled 174 patients who underwent cholecystectomy and retrospectively evaluated the outcomes of patients in the SC and CM groups.
Significant differences in age (71.1 vs. 61.9 years), American Society of Anesthesiologists physical status (ASA-PS), and serum C-reactive protein levels (CRP) (18.1 vs. 4.7 mg/dL) were observed between the CM and SC groups. Conversely, no significant differences were observed in the operation time (129 vs. 108 min), amount of blood loss (147 vs. 80 mL), intraoperative complications (0% vs. 5.7%), or duration of hospital stay (13.2 vs. 8.9 days) between the 2 groups. A high conversion rate (35.3%), postoperative complications (33%), and frequent drain insertions (94%) were observed in the CM group.
CM is a safe and valid surgical procedure and surgeons should not hesitate to transition to CM for patients who are of advanced age, in poor general condition (high ASA classification), or have high levels of serum CRP.
我们评估了胆囊黏膜剥离术（CM）的安全性和有效性，并将其与标准胆囊切除术（SC）的术中特点进行了比较。
我们纳入了 174 例行胆囊切除术的患者，并回顾性评估了 SC 组和 CM 组患者的结局。
CM 组和 SC 组在年龄（71.1 岁比 61.9 岁）、美国麻醉医师协会身体状况（ASA-PS）和血清 C 反应蛋白水平（CRP）（18.1 毫克/分升比 4.7 毫克/分升）方面存在显著差异。然而，两组在手术时间（129 分钟比 108 分钟）、出血量（147 毫升比 80 毫升）、术中并发症（0%比 5.7%）或住院时间（13.2 天比 8.9 天）方面无显著差异。CM 组的转换率较高（35.3%）、术后并发症较多（33%）、引流管插入频繁（94%）。
CM 是一种安全有效的手术方法，对于年龄较大、一般状况较差（ASA 分类较高）或 CRP 水平较高的患者，外科医生不应犹豫而应转为 CM 治疗。
