Dauleh M I, Rahman S, Townell N H
Strathcathro Hospital, Department of General Surgery, Brechin, Angus, UK.
J R Coll Surg Edinb. 1995 Apr;40(2):116-8.
Laparoscopic cholecystectomy has been shown to allow better postoperative pulmonary function than open cholecystectomy, with less incidence of lung atelectasis. As atelectasis following abdominal surgery is responsible for most febrile episodes in the first 48 h, it was postulated that with minimally invasive surgery there may be a parallel improvement in the incidence of postoperative fever. This study was designed to evaluate this hypothesis. Seventy-eight patients were randomly divided into two groups. Thirty-eight had an open cholecystectomy and 40 underwent the laparoscopic approach. Twenty-one of the 38 patients (55%) following open cholecystectomy had early febrile episodes compared with only 6 of the 40 (15%) in the laparoscopic cholecystectomy group. We concluded that there was a lower incidence of febrile episodes following laparoscopic cholecystectomy and suggest that this was related to improved pulmonary function and minimal surgical trauma.
腹腔镜胆囊切除术已被证明比开腹胆囊切除术能使术后肺功能更好，肺不张的发生率更低。由于腹部手术后的肺不张是术后48小时内大多数发热情况的原因，因此推测微创手术可能会使术后发热的发生率同时得到改善。本研究旨在评估这一假设。78例患者被随机分为两组。38例行开腹胆囊切除术，40例行腹腔镜手术。开腹胆囊切除术后的38例患者中有21例（55%）出现早期发热，而腹腔镜胆囊切除术组的40例中只有6例（15%）出现早期发热。我们得出结论，腹腔镜胆囊切除术后发热的发生率较低，并认为这与肺功能改善和手术创伤最小有关。
