目的:探讨腹腔镜手术治疗复杂性胆囊炎的安全性及可行性.方法:回顾分析186例复杂性胆囊炎患者手术资料, 其中腹腔镜手术治疗102例, 开腹手术治疗84例, 比较两组不同术式的切除率、手术时间、术中出血量、胆道损伤、疼痛评分、切口感染、胆漏、残余结石、住院时间、胆囊造瘘后二期腹腔镜胆囊切除率等方面的差异.结果:腹腔镜胆囊切除术组不同手术方式 (胆囊切除术、胆囊次全切除术、胆囊造瘘术) 切除率分别为24.5％、55.8％及16.6％, 与开腹胆囊切除术组相应手术切除率 (26.2％、57.1％、14.3％) 比较差异无统计学意义 (P>0.05) ;两组手术时间[ (126.51±42.58) min与 (138.36±55.46) min]、胆道损伤 (2.0％与2.4％) 、残余结石 (2.9％与2.4％) 、胆漏 (6.9％与7.1％) 比较差异均无统计学意义 (P>0.05) ;两组术中出血量[ (78.56±22.13) ml与 (115.46±32.56) ml]、疼痛评分[ (5.5±1.8) 分与 (8.4±2.1) 分]、住院时间[ (8.5±1.3) d与 (13.4±2.6) d]、切口感染率 (1.9％与10.7％) 及胆囊造瘘后二期腹腔镜胆囊切除率 (82％与33％) 比较差异有统计学意义 (P0.05), but the difference in amount of blood loss[ (78.56±22.13) ml vs (115.46±32.56) ml], pain rating index[ (5.5±1.8) marks vs (8.4±2.1) marks], hospital stay time[ (8.5±1.3) d vs (13.4±2.6) d], wound infection rate (1.9％ vs 10.7％) and secondary laparoscopic cholecystectomy rate (82％ vs 33％) was statistically significant (P<0.05).The laparoscopic cholecystectomy group was better than open cholecystectomy group.Conclusion:Under the skillful operative technique and the strict selection of operation indications, laparoscopic cholecystectomy is safe.
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