Strekalovskiĭ V P, Starkov Iu G, Grishin N A, Beliaev M V, Kotovskiĭ A E, Riapolov I A, Gorev M P
Khirurgiia (Mosk). 1993 Mar(3):68-73.
Two alternative methods for the treatment of calculous cholecystitis are evaluated: extracorporeal lithotripsy was performed in 284 patients, laparoscopic cholecystectomy--in 130 patients. Even in strict selection of patients, lithotripsy was ineffective in 32 of them and they were subjected to an operation; in another group of patients elimination of the fragments from the gallbladder was incomplete. Therefore, extracorporeal lithotripsy may be used in no more than 10% of patients with cholelithiasis. Laparoscopic cholecystectomy was conducted in 130 patients. In 6 (4.5%) of them the operation had to be completed by laparotomy because complications occurred during the laparoscopic intervention. Laparoscopic cholecystectomy has some obvious advantages over open cholecystectomy: easier postoperative period, early activation of the patients, a good cosmetic effect. However, to determine the boundaries and possibilities of this method accumulation of experience is needed.
284例患者接受了体外碎石术,130例患者接受了腹腔镜胆囊切除术。即使严格筛选患者,仍有32例体外碎石术无效,这些患者接受了手术;另一组患者胆囊内结石碎片清除不完全。因此,体外碎石术在不超过10%的胆石症患者中适用。130例患者接受了腹腔镜胆囊切除术。其中6例(4.5%)因腹腔镜手术期间出现并发症而不得不通过开腹手术完成手术。腹腔镜胆囊切除术与开腹胆囊切除术相比具有一些明显优势:术后恢复更容易、患者能更早活动、美容效果好。然而,要确定该方法的适用范围和可能性,还需要积累经验。