肝胆胰外科杂志2026，Vol.39Issue(4)：255-259,5.DOI:10.11952/j.issn.1007-1954.2026.04.004
腹腔镜及开腹胆囊癌根治术对早期胆囊癌患者术后应激反应的影响比较
Laparoscopic versus open radical cholecystectomy for early-stage gallbladder cancer:A comparative analysis of postoperative stress response
摘要
Abstract
Objective To compare the effects of laparoscopic versus open radical cholecystectomy on the postoperative stress response in patients with early-stage gallbladder cancer,and to assess the safety profile of the laparoscopic approach.Methods A total of 82 patients with early-stage gallbladder cancer who underwent surgical treatment in Ningbo Yinzhou No.2 Hospital were retrospectively enrolled between January 2017 and May 2024.They were allocated to either the laparoscopic group(n=38)or the open group(n=44)based on the surgical technique employed.Perioperative clinical outcomes and biological markers of stress response were compared between the two groups.Results Baseline characteristics including gender distribution,age,preoperative comorbidities,and body mass index(BMI),showed no significant differences between the two groups(P>0.05).The laparoscopic group exhibited significantly shorter operative time,less intraoperative blood loss,and a reduced postoperative hospital stay compared with the open group(P<0.05).No statistically significant differences were observed between the groups in terms of lymph node dissection yield,postoperative complication rates,extent of liver resection,or pathological T and N staging(P>0.05).Preoperatively(1 day before surgery),the levels of C-reactive protein(CRP),malondialdehyde(MDA),superoxide dismutase(SOD),white blood cell(WBC)count,alanine aminotransferase(ALT),and aspartate aminotransferase(AST)were comparable between the two groups(P>0.05).On postoperative days 1 and 3,the laparoscopic group had significantly lower levels of CRP,MDA,WBC count,ALT,and AST,and significantly higher SOD levels,compared with the open group(P<0.05).Conclusion Laparoscopic radical cholecystectomy achieves equivalent lymph node dissection efficacy to open surgery in patients with early-stage gallbladder cancer.Additionally,it offers the advantages of reduced intraoperative blood loss,faster postoperative recovery,and attenuated systemic stress response.Thus,laparoscopic radical cholecystectomy is a safe and feasible option for early-stage gallbladder cancer in high-volume,experienced hepatobiliary surgery centers.关键词
胆囊癌根治术/腹腔镜手术/开腹术式/应激反应Key words
radical cholecystectomy/laparoscopy/open operation/stress response分类
医药卫生引用本文复制引用
郝龙,尹杰,蔡健开,沙洪存..腹腔镜及开腹胆囊癌根治术对早期胆囊癌患者术后应激反应的影响比较[J].肝胆胰外科杂志,2026,39(4):255-259,5.基金项目
宁波市鄞州区科学技术项目(2022AS068). （2022AS068）
