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[既往胃切除术会增加腹腔镜胆囊切除术的风险吗?一项病例对照研究]

[Does previous gastric resection increase the risks of laparoscopic cholecystectomy? A case-control study].

作者信息

Pezzolla F, Lorusso D

机构信息

Divisione di Chirurgia, Istituto di Ricovero e Cura a Carattere Scientifico S. De Bellis Castellana Grotte, Bari.

出版信息

Minerva Chir. 1998 Jul-Aug;53(7-8):603-7.

PMID:9793348
Abstract

BACKGROUND

Videolaparocholecystectomy is now regarded as the elective surgical technique for the treatment of cholelithiasis.

AIMS

In order to evaluate the feasibility and risks of videolaparocholecystectomy in patients with previous upper abdominal surgery the authors performed a retrospective case-control study in a group of 15 patients with cholelithiasis who had previously undergone gastrectomy for peptic ulcer (group A) and a control group of 15 patients with cholelithiasis who had not undergone upper abdominal surgery (group B).

METHODS

The control group was matched with the case group for age, sex, surgeon, indications for cholecystectomy (simple cholelithiasis, acute cholecystitis). The following parameters were compared in both groups: laparotomic conversion rate (33% in group A vs 20% in group B; p = 0.317), postoperative complications (0% in group A vs 13% in group B, p = 0.157), reoperations (0% in group A vs 13% in group B, p = 0.157), duration of surgery (median of 78 minutes in group A vs 80 minutes in group B; p = 1.000), duration of postoperative hospital stay (mean of 3 days in group A vs 3.5 days in group B, p = 0.507).

RESULTS

None of the differences between the variables examined was statistically significant.

CONCLUSIONS

The authors, conclude that videolaparocholecystectomy can be regarded as a safe and effective surgical technique for the treatment of cholelithiasis also in patients who have undergone previous upper abdominal surgery.

摘要

背景

电视腹腔镜胆囊切除术现已被视为治疗胆结石的择期手术技术。

目的

为了评估既往有上腹部手术史的患者行电视腹腔镜胆囊切除术的可行性和风险,作者对一组15例因消化性溃疡行胃切除术的胆结石患者(A组)和一组15例未行上腹部手术的胆结石对照组患者(B组)进行了一项回顾性病例对照研究。

方法

对照组在年龄、性别、手术医生、胆囊切除指征(单纯胆结石、急性胆囊炎)方面与病例组相匹配。比较两组的以下参数:开腹转换率(A组为33%,B组为20%;p = 0.317)、术后并发症(A组为0%,B组为13%,p = 0.157)、再次手术(A组为0%,B组为13%,p = 0.157)、手术时间(A组中位数为78分钟,B组为80分钟;p = 1.000)、术后住院时间(A组平均为3天,B组为3.5天,p = 0.507)。

结果

所检查变量之间的差异均无统计学意义。

结论

作者得出结论,电视腹腔镜胆囊切除术也可被视为治疗既往有上腹部手术史患者胆结石的一种安全有效的手术技术。

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