摘要
目的探讨急性结石性胆囊炎合并肝功能异常病人行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)的手术时机选择及早期行LC的可行性。方法回顾性分析合肥市第二人民医院普外科2011年1月至2017年6月期间106例胆囊结石合并肝功能异常病人,根据病人行LC的手术时间距病人发病时间72h界限分组为早期手术组(47例)和延期手术组(59例),通过收集临床资料进行研究分析。结果术前以及术后第3、5天的血总胆红素、直接胆红素、丙氨酸转氨酶、γ-谷氨酰转移酶、碱性磷酸酶早期手术组与延期手术组比较,差异均无统计学意义(均P>0.05)。早期手术组的住院时间及住院费用与延期手术组比较,差异均有统计学意义(均P<0.05);两组手术时间、术中出血量、术后并发症发生率比较,差异均无统计学意义(均P>0.05)。结论急性结石性胆囊炎合并肝功能异常的病人早期行LC可以减轻病人经济负担,同时可以有效避免部分病人的过度治疗,且安全有效。
Objective To study the feasibility and timing of early laparoscopic cholecystectomy（LC）for the patients with acute calculous cholecystitis complicated with hepatic dysfunction.Methods A retrospective analysis was performed on 106 cases of cholelithiasis complicated with hepatic dysfunction in Department of General Surgery,the Second People＇s Hospital of Hefei from January 2011 to June 2017.According to the operation timing of LC from the onset of 72 h limit,the patients were grouped into the early surgery group（n=47）and the delayed operation group（n=59）.The clinical data were collected and analyzed.Results There were no significant differences between the two groups in total bilirubin,direct bilirubin,alanine aminotransferase,gamma glutamyl transferase,alkaline phosphatase before and on the postoperative day 3 and 5（P〉0.05）.There were significant differences between the two groups in expenses and hospital stay（P〈0.05）.There were no significant differences between the two groups in the operation time,the amount of blood loss and the incidence of postoperative complications（P〉0.05）.Conclusions The early LC for patients with acute calculous cholecystitis complicated with hepatic dysfunction can reduce the economic burden of patients and effectively avoid excessive treatment in some patients,and is safe and effective.
作者
李文波
李良
张军
杨仁保
鲁俊
陈宏存
Li Wenbo;Li Liang;Zhang Jun;Yang Renbao;Lu Jun;Chen Hongcun(Department of General Surgery,the Second People ＇ s Hospital of Hefei,Hefei 230001,China)
出处
《腹部外科》
2018年第3期206-209,共4页
Journal of Abdominal Surgery
关键词
胆囊结石
胆囊切除术
肝功能异常
腹腔镜
Gallbladder stone
Cholecystectomy
Hepatic dysfunction
Laparoscopy
