Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
J Laparoendosc Adv Surg Tech A. 2023 Dec;33(12):1211-1217. doi: 10.1089/lap.2023.0328. Epub 2023 Oct 3.
Compare the clinical efficacy of anterior and posterior Calot's triangle approach in laparoscopic cholecystectomy (LC) for chronic atrophic cholecystitis, to find out which approach is much safer and more reliable. From June 2020 to June 2022, 102 patients with chronic atrophic cholecystitis underwent LC in our hospital. They were divided into anterior Calot's triangle approach group and posterior Calot's triangle approach group. In addition, their clinical data, intraoperative conditions, surgical results, and postoperative recovery were analyzed. LC was performed in 41 females and 28 males by the anterior Calot's triangle approach, and in 20 females and 13 males by the posterior Calot's triangle approach. There were no differences in age, gender, and body mass index between the two groups ( > .05). The probability of rupture of cystic artery between both groups was not significantly different ( = .549), and the intraoperative blood loss was more in the anterior group ( = .014). The operative time of the posterior approach appeared to be shorter ( = .013). Bile duct injury and conversion to open cholecystectomy revealed no significant difference ( > .05). The recovery time of gastrointestinal function, wound infection, white blood cell count, liver function, and postoperative hospital stay time were found to be not significantly different ( > .05). By the posterior Calot's triangle approach, LC is a convenient and feasible surgical procedure for chronic atrophic cholecystitis with less blood loss and can become easier without increasing the risk of surgery.
比较腹腔镜胆囊切除术(LC)中前三角和后三角 Calot 入路治疗慢性萎缩性胆囊炎的临床疗效,以找出哪种方法更安全可靠。 2020 年 6 月至 2022 年 6 月,我院收治慢性萎缩性胆囊炎患者 102 例,分为前三角 Calot 入路组和后三角 Calot 入路组,分析其临床资料、术中情况、手术结果及术后恢复情况。 采用前三角 Calot 入路治疗女性 41 例,男性 28 例;采用后三角 Calot 入路治疗女性 20 例,男性 13 例。两组年龄、性别、体质量指数比较差异无统计学意义( > .05)。两组胆囊动脉破裂的概率差异无统计学意义( = .549),且前组术中出血量较多( = .014)。后入路组的手术时间似乎更短( = .013)。胆管损伤和转为开腹胆囊切除术的发生率差异无统计学意义( > .05)。胃肠功能恢复时间、伤口感染、白细胞计数、肝功能、术后住院时间差异无统计学意义( > .05)。 后三角 Calot 入路 LC 治疗慢性萎缩性胆囊炎,操作方便,可行性好,术中出血量少,且不会增加手术风险。