摘要
Abstract
Objective To investigate the best timing of laparoscopic cholecystectomy for acute calculous cholecystitis and influencing factors for conversion to open surgery. Methods 230 patients with acute calculous cholecystitis underwent laparo-
scopic cholecystectomy in our hospital from Jimp 2007 to Jimp 2012 were divided into four groups according to the time from onset to underwent laparoscopic cholecystectomy: Group I ( 74 cases ), within 48 h; group II ( 69 cases ), from 48 h to 72 h; group III ( 53 cases ), after72h; group IV ( 34 cases ) . After admitted to the hospital, all the patients were given anti - infec-
tious, symptomatic anrl supportive treatment, and were given laparoscopic cliolecystectomy alter the symptoms relieved lor two to four weeks. The incidence of complications, rate of conversion to open surgery and operating time were compared between the four groups, and influencing factors for conversion to open surgery were also analyzed. Results The incidence of complications between the four groups showed no statistically significant difference ( X2 = 1- 26, P > 0. 05 ), but the rate of conversion to open surgery and operating time showed statistically significant differences ( X2 = 5. 77, P < 0. 05 ; F = 7. 99, P < 0. 01 ) . Single factor analysis showed that body temperature, gallbladder enlargement, upper right abdominal muscle tension, white blood cell count, gallbladder wall thickness, gallbladder neck calculus incarceration and operation timing were related factors for conversion to open surgery ( P < 0. 05 ) . Multi - factor logistic regression analysis showed that white blood cell count [ r = 1. 298, OR = 3.698, 95% CI(1.867, 4.789 )] and operation timing [ r = 1. 062 , OR = 2. 265 , 95% CI( 1.688, 3. 821 ) ] antered the regression equation. Conclusion 48 h within onset of acute calculous cholecystitis is the best time for laparoscopic cholecystectomy. White blood cell count and operation timing are the two independent risk factors for conversion to open surgery.关键词
胆囊结石病/胆囊炎/胆囊切除术,腹腔镜Key words
Cholecystolithiasis/Cholecystitis/Cholecystectomy, laparoscopic分类
医药卫生
