摘要
Abstract
Objective:To investigate the effects of different laparoscopic surgical approaches on perioperative indicators,stress response,and postoperative complications in patients with acute cholecystitis.Method:A total of 315 patients with acute cholecystitis treated with laparoscopic surgery in the Third People's Hospital of Jingzhou City from January 2022 to September 2024 were selected as the study subjects.The patients were divided into a lateral group(n=165)and an anterograde/retrograde group(n=150)according to the laparoscopic surgical approach.The lateral group underwent lateral laparoscopic cholecystectomy,while the anterograde/retrograde group underwent either anterograde or retrograde laparoscopic cholecystectomy.The perioperative indicators(surgical time,drainage tube placement time,length of hospital stay,intraoperative bleeding volume and postoperative drainage volume),stress response[norepinephrine(NE),adrenocorticotropic hormone(ACTH),cortisol(Cor)],and postoperative outcomes were compared between the two groups.Result:The surgical time,length of hospital stay,and drainage tube placement time of the lateral group were shorter than those of the anterograde/retrograde group(P<0.05).Before surgery,there was no statistically significant difference in stress response between the two groups(P>0.05).24 h and 72 h after surgery,the stress response in the lateral group was lower than that in the anterograde/retrograde group,and the difference was statistically significant(P<0.05).The total incidence rate of the lateral group was significantly lower than the anterograde/retrograde group,and the difference was statistically significant(P<0.05).Conclusion:The use of lateral laparoscopic surgical approach in patients with acute cholecystitis can reduce stress response,decrease bleeding volume,improve postoperative complications,and shorten hospitalization time.关键词
腹腔镜手术/急性胆囊炎/应激反应Key words
Laparoscopic surgery/Acute cholecystitis/Stress response
