ObjectiveTo analyze the surgical effect, postoperative complications and effects on the body inflammatory response of laparoscopic gastroduodenal perforation repair, and to further evaluate the efficacy of laparoscopic perforation repair. MethodsWe retrospectively analyzed the clinical data of 123 patients with gastroduodenal ulcer perforation treated between February 2010 and February 2015. Among the patients, 65 underwent laparoscopic gastroduodenal ulcer perforation repair (laparoscopic group), and 58 underwent routine open gastroduodenal ulcer perforation repair (open group). Then, we compared the surgical effects (average bleeding volume, ambulation time, postoperative ventilation time, postoperative hospital stay), postoperative complications (wound infection, wound dehiscence, gastroduodenal fistula, abdominal abscess, intestinal obstruction), inflammatory reaction[preoperative and 1, 3, 5-day postoperative white blood cells (WBC) count, peripheral blood procalcitonin (PCT), C-reactive protein (CRP)] between the two groups. ResultsPatients in both the two groups underwent the surgery successfully. No patients in the laparoscopic group were transferred to open surgery. Compared with the open surgery, surgical bleeding volume, ambulation time, anal exhaust time and postoperative hospital stay of the laparoscopic group were significantly different (P < 0.05). Postoperative complications rate of the laparoscopic group was significantly lower than that of the open group (P < 0.05). One and 3-day WBC, PCT and CRP after surgery increased obviously in both the two groups. The above three indicators on the fifth day after surgery were not significantly different from those before the surgery in the laparoscopic group (P > 0.05), while they were significantly different from those before the surgery in the open group (P < 0.05). ConclusionsCompared with open perforation repair, laparoscopic perforation repair surgery is superior for its better surgical effects, fewer postoperative complications and lighter inflammatory response. It is a safe, effective and minimally-invasive treatment for gastroduodenal perforation.
目的探讨经脐单孔腹腔镜胆囊切除术（LC）的临床应用。方法分析我院2009年1月至2010年5月期间120例因结石性胆囊炎和胆囊息肉行经脐单孔LC患者的临床资料。结果98例患者手术成功，手术时间38～126 min，平均50.3 min。22例单孔手术失败改成两孔完成手术。住院时间2～4 d，平均2.5 d。全组患者无出血及漏胆并发症发生，仅2例（1.7%）脐部戳孔处术后轻度感染，经局部换药治疗2周愈合。89例（90.8%）采用单孔法患者获得1～15个月（平均7.3个月）随访，均无并发症发生。结论单孔LC安全可行，但使用现有腹腔镜设备操作难度较大，器械及技术尚需进一步完善。