Curative effect of laparoscopic cholecystectomy for 64 patients with acute cholecystitis

doi:10.3877/cma.j.issn.1674-0793.2015.02.013

Abstract

Abstract:

Objective

To study the clinical efficacy of laparoscopic cholecystectomy for acute cholecystitis.

Methods

One hundred and twenty-eight cases with acute cholecystitis were selected from March 2012 to June 2014. They were randomly divided into laparotomy group (64 cases, underwent open cholecystectomy) and laparoscopic group (64 cases, underwent laparoscopic cholecystectomy). Clinical data such as indicators, infection of incision, incidence of complications were compared between the two groups.T cell subsets, immunoglobulin and C-reactive protein (CRP) before and after surgery were also analyzed.

Results

For laparoscopic group, the operation time, anus exhaust time, postoperative indicators were significantly lower than those of laparotomy group (P ＜0.05). Before surgery, there was no statistical significance between the two groups on T cell subsets, immunoglobulin and CRP. For laparoscopic group, the indexes before and after operation were near (P＜0.05). The postoperative level in laparotomy group was significantly lower than preoperative level (P＜0.05), and significantly lower than that of laparoscopic group(P＜0.05). Three patients (4.69%) were transferred to laparotomy in laparoscopic group; the complications incidence was higher than that of laparotomy group, but there was no statistical difference.

Conclusions

Laparoscopic cholecystectomy has less injuries, reducing pains caused by the cut-open and long time fasting, greatly shortening the length of hospital stay, and reducing the the body's inflammatory stress response caused by surgery. It is safe after rich operating experiences and worthy of application with strict indications.

Key words: Laparoscopic cholecystectomy, Open cholecystectomy, Acute cholecystitis

Dewen He, Kaiwei Li. Curative effect of laparoscopic cholecystectomy for 64 patients with acute cholecystitis[J]. Chinese Archives of General Surgery(Electronic Edition), 2015, 09(02): 138-141.

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References 12

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组别	例数	手术时间(min)	术中出血量(ml)	卧床时间(d)	肛门排气时间(d)	肠蠕动恢复时间(h)	住院时间(d)
开腹组	64	60.53±19.64	89.45±22.31	3.82±0.42	2.96±0.42	18.53±2.64	7.96±1.86
腹腔镜组	64	40.26±17.54	40.28±19.58	2.94±0.28	1.84±0.33	30.42±4.26	5.02±1.53
t值		6.158	13.252	13.947	16.775	18.980	9.766
P值		0.001	0.000	0.000	0.000	0.000	0.000

组别	例数	手术时间(min)	术中出血量(ml)	卧床时间(d)	肛门排气时间(d)	肠蠕动恢复时间(h)	住院时间(d)
开腹组	64	60.53±19.64	89.45±22.31	3.82±0.42	2.96±0.42	18.53±2.64	7.96±1.86
腹腔镜组	64	40.26±17.54	40.28±19.58	2.94±0.28	1.84±0.33	30.42±4.26	5.02±1.53
t值		6.158	13.252	13.947	16.775	18.980	9.766
P值		0.001	0.000	0.000	0.000	0.000	0.000

组别	CD3(%)	CD4(%)	CD8(%)	IgA(g/L)	IgG(g/L)	IgM(g/L)	CRP(mg/L)
开腹组(64例)
治疗前	60.47±3.99	32.94±2.17	28.65±1.83	2.85±0.32	11.85±0.92	1.65±0.23	7.25±0.95
治疗后	52.53±3.34	27.86±1.96	26.41±1.69	1.24±0.11	9.58±0.71	0.79±0.06	7.31±1.02
腹腔镜组(64例)
治疗前	60.59±3.87	32.71±2.43	28.51±1.94	2.78±0.36	11.78±0.95	1.66±0.20	11.94±2.97
治疗后	59.22±3.26	30.53±2.08	27.92±1.81	2.69±0.28	11.69±0.82	1.54±0.17	9.87±3.02
t ₁,t₂值	0.093,8.712	0.806,7.456	0.759,2.384	0.109,3.260	0.297,13.562	0.268,6.307	0.344,5.148
P ₁,P₂值	0.995,0.002	0.238,0.003	0.264,0.021	0.878,0.013	0.591,0.000	0.713,0.004	0.366,0.006

组别	CD3(%)	CD4(%)	CD8(%)	IgA(g/L)	IgG(g/L)	IgM(g/L)	CRP(mg/L)
开腹组(64例)
治疗前	60.47±3.99	32.94±2.17	28.65±1.83	2.85±0.32	11.85±0.92	1.65±0.23	7.25±0.95
治疗后	52.53±3.34	27.86±1.96	26.41±1.69	1.24±0.11	9.58±0.71	0.79±0.06	7.31±1.02
腹腔镜组(64例)
治疗前	60.59±3.87	32.71±2.43	28.51±1.94	2.78±0.36	11.78±0.95	1.66±0.20	11.94±2.97
治疗后	59.22±3.26	30.53±2.08	27.92±1.81	2.69±0.28	11.69±0.82	1.54±0.17	9.87±3.02
t ₁,t₂值	0.093,8.712	0.806,7.456	0.759,2.384	0.109,3.260	0.297,13.562	0.268,6.307	0.344,5.148
P ₁,P₂值	0.995,0.002	0.238,0.003	0.264,0.021	0.878,0.013	0.591,0.000	0.713,0.004	0.366,0.006

组别	例数	切口感染	腹腔感染	胆道损伤	胆瘘
开腹组	64	4(6.25)	1(1.56)	2(3.13)	1(1.56)
腹腔镜组	64	1(1.56)	2(3.13)	4(6.25)	3(4.69)
χ ²值		1.873	0.341	0.699	1.032
P值		0.365	1.000	0.680	0.619

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