Mayol Martínez J, Vicent Hamelin E, Martínez Sarmiento J, Ortiz Oshiro E, Tamayo Fernández F J, Moreno Tello B, Alvárez Fernández-Represa J
Servicio de Cirugía I, Hospital Universitario San Carlos, Madrid.
Rev Esp Enferm Dig. 1994 Aug;86(2):592-5.
Laparoscopic cholecystectomy has become the treatment of choice for symptomatic cholelithiasis. However, the indication of the laparoscopic approach for acute inflammation of the gallbladder in unclear and further analysis of the results is required. The aim of our study was to compare the results of laparoscopic cholecystectomy after uncomplicated cholelithiasis and after acute cholecystitis. Data from 201 patients who underwent laparoscopic cholecystectomy were collected prospectively. Uncomplicated cholelithiasis was present in 149 patients and 52 individuals had acute cholecystitis. No differences in age, sex distribution or associated diseases were observed between groups. The mean operative time was significantly higher in patients with acute cholecystitis. However, no difference was observed regarding conversion rate (7.3%-7.6%) and morbidity rate (8.7%-9.6%). No mortality has occurred in any group. The average hospital stay after laparoscopic cholecystectomy was greater when acute cholecystitis was present (2.6 days-4.9 days; p < 0.01). But in this case hospitalization was shorter than after elective conversion (8 days; p < 0.001 and p < 0.05). We conclude that patients with acute cholecystitis can undergo laparoscopic cholecystectomy safely, with low morbidity and mortality rates and reduced hospital stay.
腹腔镜胆囊切除术已成为有症状胆结石的首选治疗方法。然而,腹腔镜手术治疗胆囊急性炎症的适应证尚不清楚,需要进一步分析结果。我们研究的目的是比较单纯胆结石和急性胆囊炎后腹腔镜胆囊切除术的结果。前瞻性收集了201例行腹腔镜胆囊切除术患者的数据。149例患者为单纯胆结石,52例为急性胆囊炎。两组在年龄、性别分布或相关疾病方面未观察到差异。急性胆囊炎患者的平均手术时间明显更长。然而,在转化率(7.3%-7.6%)和发病率(8.7%-9.6%)方面未观察到差异。任何一组均未发生死亡。存在急性胆囊炎时,腹腔镜胆囊切除术后的平均住院时间更长(2.6天-4.9天;p<0.01)。但在这种情况下,住院时间比择期中转开腹后短(8天;p<0.001和p<0.05)。我们得出结论,急性胆囊炎患者可以安全地接受腹腔镜胆囊切除术,发病率和死亡率低,住院时间缩短。