Objective To summarize the clinical therapeutic efficacy of emergent laparoscopic cholecystectomy (LC) and emergent open cholecystectomy (OC).
Methods One hundred and thirty-three patients with acute cholecystitis from March 2011 to June 2012 in this hospital were randomly divided into emergent LC (ELC) group and emergent OC (EOC) group. The examination and treatment before and after operation were the same. The clinical data before and during operation, postoperative complications, and recovery conditions were observed and compared.
Results There was no obvious difference of the clinical data before operation between the ELC group and EOC group (P>0.05). Also, there were no significant differences of the operation time, biliary duct injury rate, postoperative bleeding rate, and reoperation rate in two groups (P>0.05). The time of postoperative anal exsufflation, time of out-of-bed activity, and postoperative hospital stay in the ELC group were significantly shorter than those in the EOC group (P<0.05), the poor incision healing rate in the ELC group was significantly lower than that in the EOC group (P<0.05), and the intraoperative blood loss in the ELC group was significantly less than that in the EOC group (P<0.05).
Conclusions ELC as compared with EOC, are less intraoperative blood loss, less postoperative complications, more rapid recovery, and do not increase operation time. In a hospital with skilled LC technique, ELC is safe and feasible, has obvious advantages of minimal invasion.
Citation:
WEN Jun,XIAO Yuqing,ZHANG Shu,PU Guangchun,PENG Qiusheng. Clinical Control Study of Emergent Laparoscopic Cholecystectomy and Emergent Open Cholecystectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(2): 195-198. doi:
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1. |
Régo RE, de Campos T, de Moricz A, et al. Cholecystectomy in the elderly:early results of open versus laparoscopic approach[J]. Rev Assoc Med Bras, 2003, 49(3):293-299.
|
2. |
黄志强. 微创外科及外科微创化与本世纪外科的发展[J]. 腹部外科, 2004, 17(2):70-72.
|
3. |
钱礼, 张启瑜. 钱礼腹部外科学[M]. 北京:人民卫生出版社, 2006:878-880.
|
4. |
吕新生. 外科学 [M]. 第6版. 北京:人民卫生出版社, 2003:570-573.
|
5. |
Osborne DA, Alexander G, Boe B, et al. Laparoscopic cholecys-tectomy:past, present, and future[J]. Surg Technol Int, 2006, 15(6):81-85.
|
6. |
黄志强. 现代腹腔镜外科学[M]. 北京:人民军医出版社, 1994:89-91.
|
7. |
Frazee RC, Roberts JW, Symmonds R, et al. What are the contraindications for laparoscopic cholecystectomy?[J]. Am J Surg, 1992, 164(5):491-494.
|
8. |
黄志强. 黄志强肝胆外科[M]. 济南:山东科学技术出版社, 2000:407-429.
|
9. |
雷海录, 张康泰, 陈勇, 等. 单中心18 726例腹腔镜胆囊切除术并发症分析及预防处理对策探讨[J]. 中华肝胆外科杂志, 2003, 9(2):79-81.
|
10. |
Bodnár S, Kelemen O, Füle A, et al. Laparoscopic cholecystectomy in acute cholecystitis[J]. Acta Chir Hung, 1999, 38(2):135-138.
|
11. |
Suter M, Meyer A. A 10-year experience with the use of laparos-copic cholecystectomy for acute cholecystitis:is it safe?[J]. SurgEndosc, 2001, 15(10):1187-1192.
|
12. |
Söderlund C, Frozanpor F, Linder S. Bile duct injuries at laparos-copic cholecystectomy:a single-institution prospective study. Acute cholecystitis indicates an increased risk[J]. World J Surg, 2005, 29(8):987-993.
|
13. |
吴声堂, 高绪仲, 汪家坤. 腹腔镜胆囊切除术适应证的探讨[J]. 中国微创外科杂志, 2002, 2(1):38-39.
|
14. |
钟华, 张宗明, 宿砚明. 急性结石性胆囊炎腹腔镜手术252例[J]. 世界华人消化杂志, 2006, 14(14):1433-1436.
|
15. |
黄建勇, 赵玉亭, 刘建文, 等. 急性胆囊炎的腹腔镜治疗[J]. 河南外科学杂志, 2007, 13(1):24-25.
|
16. |
何平, 陈生贵, 张福鑫, 等. 腹腔镜胆囊切除术1 050例分析[J]. 中国普外基础与临床杂志, 2010, 17(7):748-750.
|
17. |
Misawa T, Saito R, Shiba H, et al. Analysis of bile duct injuries (Stewart-Way classification) during laparoscopic cholecystectomy[J]. J Hepatobiliary Pancreat Surg, 2006, 13(5):427-434.
|
18. |
栾汝建, 陈亚栋. 腹腔镜与开腹胆囊切除术后胃肠动力恢复的对比研究[J]. 河南科技大学学报:医学版, 2008, 26(3):179-180.
|
19. |
马富平, 王德盛, 安东均, 等. 复杂性腹腔镜胆囊切除术手术可行性研究[J]. 中国医师杂志, 2005, 7(8):1028-1029.
|
20. |
黄知果, 孙维佳, 张阳德. 急诊腹腔镜胆囊切除术中复杂情况处理的探讨[J]. 中国内镜杂志, 2007, 13(4):353-355, 359.
|
21. |
陈建尧, 蔡秀军. 急性胆囊炎腹腔镜胆囊切除术79例临床分析[J]. 中国微创外科杂志, 2004, 4(1):69-70.
|
22. |
沈毅, 涂从银, 汪宏. 急诊腹腔镜胆囊切除术胆管损伤的预防[J]. 肝胆胰外科杂志, 2009, 21(2):143-144.
|
23. |
Way LW, Stewart L, Gantert W, et al. Causes and prevention of laparoscopic bile duct injuries:analysis of 252 cases from a human factors and cognitive psychology perspective[J]. Ann Surg, 2003, 237(4):460-469.
|
24. |
马海, 沈文来, 李杨, 等. “三孔一勾到底法”腹腔镜胆囊切除术1 260例临床总结[J]. 中国普外基础与临床杂志, 2009, 16(10): 800-802.
|
25. |
汪涛, 沈志勇. 腹腔镜胆囊切除胆管损伤的原因及预防[J]. 中国普外基础与临床杂志, 2009, 16(4):317-318.
|
26. |
Ludwig K, Bernhardt J, Lorenz D. Value and consequences ofroutine intraoperative cholangiography during cholecystectomy[J]. Surg Laparosc Endosc Percutan Tech, 2002, 12(3):154-159.
|
- 1. Régo RE, de Campos T, de Moricz A, et al. Cholecystectomy in the elderly:early results of open versus laparoscopic approach[J]. Rev Assoc Med Bras, 2003, 49(3):293-299.
- 2. 黄志强. 微创外科及外科微创化与本世纪外科的发展[J]. 腹部外科, 2004, 17(2):70-72.
- 3. 钱礼, 张启瑜. 钱礼腹部外科学[M]. 北京:人民卫生出版社, 2006:878-880.
- 4. 吕新生. 外科学 [M]. 第6版. 北京:人民卫生出版社, 2003:570-573.
- 5. Osborne DA, Alexander G, Boe B, et al. Laparoscopic cholecys-tectomy:past, present, and future[J]. Surg Technol Int, 2006, 15(6):81-85.
- 6. 黄志强. 现代腹腔镜外科学[M]. 北京:人民军医出版社, 1994:89-91.
- 7. Frazee RC, Roberts JW, Symmonds R, et al. What are the contraindications for laparoscopic cholecystectomy?[J]. Am J Surg, 1992, 164(5):491-494.
- 8. 黄志强. 黄志强肝胆外科[M]. 济南:山东科学技术出版社, 2000:407-429.
- 9. 雷海录, 张康泰, 陈勇, 等. 单中心18 726例腹腔镜胆囊切除术并发症分析及预防处理对策探讨[J]. 中华肝胆外科杂志, 2003, 9(2):79-81.
- 10. Bodnár S, Kelemen O, Füle A, et al. Laparoscopic cholecystectomy in acute cholecystitis[J]. Acta Chir Hung, 1999, 38(2):135-138.
- 11. Suter M, Meyer A. A 10-year experience with the use of laparos-copic cholecystectomy for acute cholecystitis:is it safe?[J]. SurgEndosc, 2001, 15(10):1187-1192.
- 12. Söderlund C, Frozanpor F, Linder S. Bile duct injuries at laparos-copic cholecystectomy:a single-institution prospective study. Acute cholecystitis indicates an increased risk[J]. World J Surg, 2005, 29(8):987-993.
- 13. 吴声堂, 高绪仲, 汪家坤. 腹腔镜胆囊切除术适应证的探讨[J]. 中国微创外科杂志, 2002, 2(1):38-39.
- 14. 钟华, 张宗明, 宿砚明. 急性结石性胆囊炎腹腔镜手术252例[J]. 世界华人消化杂志, 2006, 14(14):1433-1436.
- 15. 黄建勇, 赵玉亭, 刘建文, 等. 急性胆囊炎的腹腔镜治疗[J]. 河南外科学杂志, 2007, 13(1):24-25.
- 16. 何平, 陈生贵, 张福鑫, 等. 腹腔镜胆囊切除术1 050例分析[J]. 中国普外基础与临床杂志, 2010, 17(7):748-750.
- 17. Misawa T, Saito R, Shiba H, et al. Analysis of bile duct injuries (Stewart-Way classification) during laparoscopic cholecystectomy[J]. J Hepatobiliary Pancreat Surg, 2006, 13(5):427-434.
- 18. 栾汝建, 陈亚栋. 腹腔镜与开腹胆囊切除术后胃肠动力恢复的对比研究[J]. 河南科技大学学报:医学版, 2008, 26(3):179-180.
- 19. 马富平, 王德盛, 安东均, 等. 复杂性腹腔镜胆囊切除术手术可行性研究[J]. 中国医师杂志, 2005, 7(8):1028-1029.
- 20. 黄知果, 孙维佳, 张阳德. 急诊腹腔镜胆囊切除术中复杂情况处理的探讨[J]. 中国内镜杂志, 2007, 13(4):353-355, 359.
- 21. 陈建尧, 蔡秀军. 急性胆囊炎腹腔镜胆囊切除术79例临床分析[J]. 中国微创外科杂志, 2004, 4(1):69-70.
- 22. 沈毅, 涂从银, 汪宏. 急诊腹腔镜胆囊切除术胆管损伤的预防[J]. 肝胆胰外科杂志, 2009, 21(2):143-144.
- 23. Way LW, Stewart L, Gantert W, et al. Causes and prevention of laparoscopic bile duct injuries:analysis of 252 cases from a human factors and cognitive psychology perspective[J]. Ann Surg, 2003, 237(4):460-469.
- 24. 马海, 沈文来, 李杨, 等. “三孔一勾到底法”腹腔镜胆囊切除术1 260例临床总结[J]. 中国普外基础与临床杂志, 2009, 16(10): 800-802.
- 25. 汪涛, 沈志勇. 腹腔镜胆囊切除胆管损伤的原因及预防[J]. 中国普外基础与临床杂志, 2009, 16(4):317-318.
- 26. Ludwig K, Bernhardt J, Lorenz D. Value and consequences ofroutine intraoperative cholangiography during cholecystectomy[J]. Surg Laparosc Endosc Percutan Tech, 2002, 12(3):154-159.