摘要
目的探讨急性胆囊炎患者行经皮经肝穿刺胆囊引流术(PTGBD)术后序贯行腹腔镜胆囊切除术(LC)的最佳手术时机。方法回顾性分析2019年10月至2022年10月在郑州大学第一附属医院先行PTGBD手术后行序贯LC手术的100例急性胆囊炎患者的临床资料。依据患者行PTGBD手术后序贯LC手术的间隔时间分为A组47例(PTGBD后5~8周行LC术)与B组53例(PTGBD后3~4周行LC术)。比较两组一般资料、围手术期指标、炎症因子及并发症发生率。结果两组OTGBD术后序贯LC术前年龄、白细胞计数、γ-谷氨酰转肽酶、美国麻醉医师协会分级、察尔森合并症指数评分及性别差异无统计学意义(P>0.05)。A组术中出血量少于对照组,手术时间、排气时间及住院时间均短于B组,差异有统计学意义(P<0.05),但两组胆囊壁厚度差异无统计学意义(P>0.05)。A组肿瘤坏死因子、白细胞介素-2及C反应蛋白水平均低于B组,差异有统计学意义(P<0.05)。A组并发症发生率(4.26%)低于B组(18.87%),差异有统计学意义(P<0.05)。两组中转开腹例数差异无统计学意义(P>0.05)。结论急性胆囊炎患者PTGBD术后序贯LC术的最佳手术时机为PTGBD术后5~8周。
Objective To investigate the optimal timing of laparoscopic cholecystectomy(LC)after percutaneous transhepatic gallbladder drainage(PTGBD)in patients with acute cholecystitis.Methods The clinical data of 100 patients with acute cholecystitis who underwent LC after PTGBD in the First Affiliated Hospital of Zhengzhou University from October 2019 to October 2022 were analyzed retrospectively.According to the interval between LC and PTGBD,the patients were divided into group A(47 patients undergoing LC at 5-8 weeks after PTGBD)and group B(53 patients undergoing LC at 3-4 weeks after PTGBD).General data,perioperative indicators,inflammatory factors and the incidence of complications were compared between groups.Results There were no statistically significant differences in age,white blood cell count,gamma-glutamyltransferase,American Society of Anesthesiologists classification,Charlson Comorbidity Index score,or gender between the two groups before LC after PTGBD(P>0.05).Intraoperative blood loss of group A were less than those of group B,and operation time,exhaust time and hospital stay of group A were shorter than those of group B(P<0.05).The thickness of gallbladder wall was similar in the two groups(P>0.05).The levels of tumor necrosis factor,interleukin-2 and C-reactive protein in group A were lower than those in group B(P<0.05).The incidence of complications in group A(4.26%)was lower than that in group B(18.87%)(P<0.05).There was no difference in the numbers of patients undergoing conversion to open surgery between the two groups(P>0.05).Conclusion The optimal timing of LC after PTGBD for patients with acute cholecystitis is 5-8 weeks after PTGBD.
作者
程国凌
徐化楠
刘义宾
CHENG Guoling;XU Huanan;LIU Yibin(Department of Emergency Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《河南医学研究》
CAS
2024年第1期57-60,共4页
Henan Medical Research
关键词
急性胆囊炎
经皮经肝穿刺胆囊引流术
胆囊切除术
手术时机
acute cholecystitis
percutaneous transhepatic gallbladder drainage
cholecystectomy
surgical timing
