摘要
目的评价不同时机行腹腔镜胆囊切除术(LC)治疗发病超过72 h的急性结石性胆囊炎的效果。方法回顾性分析2016年1月~2022年5月由笔者主刀的164例发病超过72 h行LC的急性结石性胆囊炎病例。按手术时机分为早期LC组(n=80)与延期LC组(n=84)。采用倾向性评分匹配(PSM)比较两组患者的术中情况、术后并发症发生率及术后住院时间。结果应用PSM对两组患者行1∶1匹配,成功匹配66对患者,两组患者均无胆管损伤、术后腹腔感染、腹腔出血情况,中转开腹率及胆漏、切口感染并发症发生率比较,差异无统计学意义(P>0.05)。延期组手术时间、术中出血量、放置引流管例数、采用Trocar孔数及术后住院时间均明显少于早期组,差异具有统计学意义(P<0.05)。结论延期行LC治疗发病超过72h的急性结石性胆囊炎是一种较佳的选择。
Objective To observe the effect of laparoscopic cholecystectomy(LC)in the treatment of acute calculous cholecystitis with the onset of more than 72 hours at different times.Methods 164 cases of acute calculous cholecystitis with the onset of more than 72 hours underwent LC by the author from Janaury 2016 to May 2022 were retrospectly analyzed.The patients were divided into early LC group(n=80)and delayed LC group(n=84)according to different surgical opportunities.Compared intraoperative condition,postoperative hospitalization day and the surgical complications by propensity score matching analysis.Results Using 1:1 nearest neighbor matching,66 pairs of patients were successfully matched.There was no bile duct injury,postoperative intraabdominal bleeding or infection in two groups.The conversion rate from laparoscopic to open cholecystectomy,the incidence of postoperative complications including biliary leakage and trocar incision infection were no significance differences between two groups(P>0.05).However,in delayed LC group,the operation time,intraoperative bleeding volume,cases with intraoperative drainage tube placement,the trocar hole number and postoperative hospitalization day were significantly less than those in early LC group(P<0.05).Conclusion Delayed LC for acute calculous cholecystitis more than 72 hours is a better choice.
作者
夏咸军
魏胜
潘融锡
濮毅峰
XIA Xian-jun;WEI Sheng;PAN Rong-xi(Wuxi City Rehabilitation Hospital,Wuxi 214043,China.;不详)
出处
《医师在线》
2024年第8期44-48,共5页
Journal of Doctors Online
关键词
腹腔镜胆囊切除
急性胆囊炎
手术时机
倾向性评分匹配
Laparoscopic cholecystectomy
Acute calculous cholecystitis
Timing of surgery
Propensity score matching
