Comparative analysis between laparoscopic surgery and laparotomy in the treatment of acute gangrenous cholecystitis

doi:10.3877/cma.j.issn.1674-6899.2016.03.004

Abstract

Abstract:

Objective

To compare the superiority between laparoscopic surgery and laparotomy in treating acute gangrenous cholecystitis.

Methods

The 84 patients with acute gangrenous cholecystitis were collected from Jan. 2010 to Oct. 2015, which were divided into LC group (53 cases) and OC group (31 cases). The intraoperative and postoperative situations of the two groups were compared.

Results

All the 84 patients were operated successfully. No difference existed in operation time and costs(P>0.05), but the difference in amount of intraoperative bleeding[(86.7 ±12)ml vs (120.4 ± 18) ml], length of incision[(3.1 ± 0.4)cm vs (13.2 ± 2.7)cm], pain rating index[(5.3 ± 2.1) marks vs (8.6 ± 1.9) marks], intestinal function recovery time[(20.6 ± 6.5) h vs (34.5 ± 4.7) h], wound infection rate (1.8% vs 12.9%), hospital stay time[(7.6 ± 1.8) d vs (13.4 ± 4.8)d] and changes of serum bilirubin level was statistically significant (P<0.05), The LC group was better than OC group.

Conclusions

Under the strict selection of operation indications and premise surgery operation, LC in treating acute gangrenous cholecystitis has short hospitalization time and low cost of hospitalization.

Key words: Acute gangrenous cholecystitis, Laparoscopic cholecystectomy, Open cholecystectomy, Comparative effectiveness research

Zhipeng Zhou, Xianglong Tan, Chenggang Li, Zhiming Zhao, Dadong Wang. Comparative analysis between laparoscopic surgery and laparotomy in the treatment of acute gangrenous cholecystitis[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(03): 139-141.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2016.03.004

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2016/V09/I03/139

Figures/Tables 2

References 15

1	Coccolini F, Catena F, Pisano M, et al. Open versus laparoscopic cholecystectomy in acute cholecystitis. Systematic review and meta-analysis[J]. Int J Surg, 2015, 24(18): 196-204.
2	魏裔伦. 腹腔镜治疗急性坏疽性胆囊炎疗效及危险因素分析[J]．海南医学院学报，2013，19(4): 510-513.
3	Kiviluoto T, Sirén J, Luukkonen P, et al. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis[J]. Lancet, 1998, 351(9099): 321-325.
4	Fagan SP, Awad SS, Rahwan K, et al. Prognostic factors for the development of gangrenous cholecystitis[J]. Am J Surg, 2003, 186(5): 481-485.
5	牛晓明，赵瑛. 急性坏疽性胆囊炎的临床诊治和手术技巧的体会[J]. 山西医科大学学报，2010, 41(3): 262-264.
6	Ganapathi AM, Speicher PJ, Englum BR, et al. Gangrenous cholecystitis: a contemporary review[J]. J Surg Res, 2015, 197(1): 18-24.
7	陈刚，张炳太. 急性坏疽性胆囊炎危险因素的研究进展[J]．中国现代医药杂志，2013，15(2): 103-105.
8	吴阶平，裘法祖. 黄家驷外科学[M]. 6版. 北京：人民卫生出版社，2000：174-1275.
9	McChesney JA, Northup PG, Bickston SJ. Acute acalculous cholecystitis associated with systemic sepsis and visceral arterial hypoperfusion: a case series and review of pathophysiology[J]. Dig Dis Sci, 2003, 48(10): 1960-1967.
10	赵俊. 腹腔镜与开腹手术治疗急性胆囊炎的临床疗效对比分析[J]．中国当代医药，2013，20(4): 53-54.
11	刘志贤，阚永丰，刘会东，等. 老年急性胆囊炎复杂性腹腔镜胆囊切除术治疗体会[J]．中国民康医学，2013，25(4): 29-39.
12	向阳，陈进宏，蔡端，等. 急性胆囊炎并发胆囊坏疽的相关危险性因素分析[J]．中国临床医学，2008，15(2): 193-194.
13	Bouassida M, Mroua B, Zribi S, et al. Usefulness of Laparoscopy in Gangrenous Cholecystitis[J]. Surg Laparosc Endosc Percutan Tech, 2016, 26(1): 90-92.
14	Haga Y, Beppu T, Doi K, et al. Systemic inflammatory response syndrome and organ dysfunction following gastrointestinal surgery[J]. Crit Care Med, 1997, 25(12): 1994-2000.
15	Khan A, Hsee L, Mathur S, et al. Damage-control laparotomy in nontrauma patients: review of indications and outcomes[J]. J Trauma Acute Care Surg, 2013, 75(3): 365-368.

项目	LC组(53例)	OC组(31例)	P值
手术时间(h)	2.0±0.6	2.2±0.7	0.29
术中出血量(ml)	86.7±12.0	120.4±18.0	<0.05
切口长度(cm)	3.1±0.4	13.2±2.7	<0.05
术后8 h疼痛评分(分)	5.3±2.1	8.6±1.9	<0.05
术后排气时间(h)	20.6±6.5	34.5±4.7	<0.05
切口感染率(%)	1.8	12.9	<0.05
住院时间(d)住院费用(元)	7.6±1.814 380.2±843.1	13.4±4.814 830.4±444.8	<0.050.58

项目	LC组(53例)	OC组(31例)	P值
手术时间(h)	2.0±0.6	2.2±0.7	0.29
术中出血量(ml)	86.7±12.0	120.4±18.0	<0.05
切口长度(cm)	3.1±0.4	13.2±2.7	<0.05
术后8 h疼痛评分(分)	5.3±2.1	8.6±1.9	<0.05
术后排气时间(h)	20.6±6.5	34.5±4.7	<0.05
切口感染率(%)	1.8	12.9	<0.05
住院时间(d)住院费用(元)	7.6±1.814 380.2±843.1	13.4±4.814 830.4±444.8	<0.050.58

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