临床普外科电子杂志 ›› 2023, Vol. 11 ›› Issue (3): 34-.

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不同胆囊三角解剖入路腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎的临床疗效

  

  1. 兴化市中医院 普外科,江苏 兴化 225700
  • 出版日期:2023-07-01 发布日期:2023-09-04

Clinical efficacy of laparoscopic cholecystectomy via different anatomical approaches of gallbladder triangle in the treatment of cholelithiasis with chronic cholecystitis

  1. General Surgery Department of Xinghua Hospital of Traditional Chinese Medicine, Jiangsu Xinghua 225700, China
  • Online:2023-07-01 Published:2023-09-04

摘要:

目的 探讨不同胆囊三角解剖入路腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎的疗效。方法 选择2020 年6 月至2021 年12 月兴化市中医院收治的胆囊结石合并慢性胆囊炎的住院患者150 例,采用随机数字表法分为对照组(n=75)与观察组(n=75),对照组患者采用胆囊三角入路,观察组采用胆囊后三角解剖入路。比较两组手术相关指标,治疗前后C 反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子(tumor necrosis factor,TNF)-α、白介素(interleukin,IL)-6 水平,以及并发症发生情况及中转开腹情况。结果 观察组患者的手术时间、胃肠功能恢复时间及住院时间均短于对照组,出血量少于对照组,差异均有显著性(P < 0.05)。术后,观察组患者的CRP、TNF-α、IL-6 水平均低于对照组,并发症发生率、中转开腹率也低于对照组,差异均有显著性(P < 0.05)。结论 腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎者,给予后三角解剖入路能减少患者损伤,有利于患者康复,可减轻机体炎症反应,降低并发症发生率及中转开腹风险。

关键词: 胆囊结石, 腹腔镜, 胆囊炎, 后三角解剖入路, 并发症

Abstract:

Objective To investigate the effect of laparoscopic cholecystectomy through different anatomical approaches of gallbladder triangle in the treatment of cholecystolithiasis with chronic cholecystitis. Method From June 2020 to December 2021, 150 in-patients with gallstones and chronic cholecystitis admitted to Xinghua Hospital of Traditional Chinese Medicine were selected. They were randomly divided into the control group (n=75) and the observation group (n=75). The patients in the control group used the triangular approach to the gallbladder, and the patients in the observation group used the posterior triangular approach to the gallbladder. Compare the levels of C-reactive protein (CRP), tumor necrosis factor (TNF)-α, interleukin-6 (IL-6) before and after treatment between two groups of surgical related indicators, as well as the incidence of complications and conversion to

open surgery. Result The surgery time, gastrointestinal function recovery time, and hospitalization time of the observation group patients were shorter than those of the control group, and the bleeding volume was smaller than that of the control group, with significant differences (P < 0.05). After surgery, the average levels of CRP, TNF-α, and IL-6 in the observation group were lower than those in the control group, and the incidence of complications and conversion to laparotomy were also lower than those in the control group, with significant differences (P<0.05). Conclusion Laparoscopic cholecystectomy for the treatment of gallstones with chronic cholecystitis can reduce the injury of patients, help patients recover, reduce the inflammatory reaction of the body, and reduce the risk of complications and conversion to laparotomy.

Key words: Gallstone, Laparoscopy, Cholecystitis, Posterior triangular dissection approach, Complications