ABSTRACT
Objective To investigate the clinical effect of laparoscopic surgery on acute cholecystitis with calculi.Methods Clinical data of 126 patients with acute cholecystitis and calculi treated with laparoscopic surgery from March 2014 to March 2018 were retrospectively analyzed.Results Of the 126 patients treated with laparoscopic surgery,123 operations went smoothly,3 cases were converted to laparotomy.One patient developed inflammatory intestinal obstruction 48 hours after surgery, the remaining 122 patients recovered smoothly after surgery , no complications occurred.Conclusion Laparoscopic surgery for acute cholecystitis with calculi has a significant effect on patients within 72 hours of the acute phase of the onset , while intraoperative laparotomy is the ultimate guarantee for the treatment of acute cholecystitis.In clinical treatment,the appropriate operation method should be selected according to the overall situation of patients.
ABSTRACT
Objective@#To investigate the clinical effect of laparoscopic surgery on acute cholecystitis with calculi.@*Methods@#Clinical data of 126 patients with acute cholecystitis and calculi treated with laparoscopic surgery from March 2014 to March 2018 were retrospectively analyzed.@*Results@#Of the 126 patients treated with laparoscopic surgery, 123 operations went smoothly, 3 cases were converted to laparotomy.One patient developed inflammatory intestinal obstruction 48 hours after surgery, the remaining 122 patients recovered smoothly after surgery, no complications occurred.@*Conclusion@#Laparoscopic surgery for acute cholecystitis with calculi has a significant effect on patients within 72 hours of the acute phase of the onset, while intraoperative laparotomy is the ultimate guarantee for the treatment of acute cholecystitis.In clinical treatment, the appropriate operation method should be selected according to the overall situation of patients.
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ObjectiveTo analyze the influencing factors for conversion of laparoscopic cholecystectomy to open surgery, and to provide a clinical reference for developing surgical procedures. MethodsA total of 278 patients receiving laparoscopic cholecystectomy in our hospital from January 2009 to December 2013 were analyzed. Among them, 31 patients were converted to open surgery during laparoscopic cholecystectomy, while the remaining 274 patients were not. The influencing factors for conversion to open surgery were investigated. The t test was applied in the comparison of continuous data, whereas the χ2 test was used for categorical data. The univariate logistic regression analysis was performed to investigate significant influencing factors, and the independent influencing factors were determined by multivariate logistic regression analysis. ResultsThe univariate analysis showed that sex (P=0.022), arteriosclerosis (P＜0.001), diabetes (P＜0.001), heart failure (P=0.002), previous upper abdominal surgery (P＜0.001), age (P＜0.001), body mass index (BMI) (P=0.003), gallbladder wall thickness (P＜0.001), the count of white blood cells (P＜0.001), and serum total bilirubin level (P=0.046) were significantly different between groups. The multivariate logistic regression analysis further showed that previous upper abdominal surgery (P＜0.001), sex (P=0.001), BMI (P=0.002), and the count of white blood cells (P=0.019) were independent influencing factors, among which previous upper abdominal surgery was the most significant one (OR=4.646， 95%CI: 2.012-10.729). ConclusionPrevious upper abdominal surgery, sex, BMI, and the count of white blood cells were independent influencing factors for conversion of laparoscopic cholecystectomy to open surgery. Careful evaluation of these factors before surgery would help to increase the operation efficacy, possessing an important clinical value.
ABSTRACT
ObjectiveTo analyze the influencing factors for conversion of laparoscopic cholecystectomy to open surgery, and to provide a clinical reference for developing surgical procedures. MethodsA total of 278 patients receiving laparoscopic cholecystectomy in our hospital from January 2009 to December 2013 were analyzed. Among them, 31 patients were converted to open surgery during laparoscopic cholecystectomy, while the remaining 274 patients were not. The influencing factors for conversion to open surgery were investigated. The t test was applied in the comparison of continuous data, whereas the χ2 test was used for categorical data. The univariate logistic regression analysis was performed to investigate significant influencing factors, and the independent influencing factors were determined by multivariate logistic regression analysis. ResultsThe univariate analysis showed that sex (P=0.022), arteriosclerosis (P＜0.001), diabetes (P＜0.001), heart failure (P=0.002), previous upper abdominal surgery (P＜0.001), age (P＜0.001), body mass index (BMI) (P=0.003), gallbladder wall thickness (P＜0.001), the count of white blood cells (P＜0.001), and serum total bilirubin level (P=0.046) were significantly different between groups. The multivariate logistic regression analysis further showed that previous upper abdominal surgery (P＜0.001), sex (P=0.001), BMI (P=0.002), and the count of white blood cells (P=0.019) were independent influencing factors, among which previous upper abdominal surgery was the most significant one (OR=4.646， 95%CI: 2.012-10.729). ConclusionPrevious upper abdominal surgery, sex, BMI, and the count of white blood cells were independent influencing factors for conversion of laparoscopic cholecystectomy to open surgery. Careful evaluation of these factors before surgery would help to increase the operation efficacy, possessing an important clinical value.
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Objective To study the optimal laparoscopic procedure and its indication for remove of common bile duct stone. Methods Analysis was made on the clmical data of 124 cases of laparoscopic choledocholithotomy and T tube drainage in our center.Results 82 patients underwent the improved laparoscopic procedure, alternation to open operation in 4 cases (4.9%),and the mean operating time was (80?30) min. While 42 patients were operated with traditional laparoscopic method,changing to open operation in 6 cases (14.3%),and the mean operating time was (170?40) min . The improved method could shorten the operation time and reduce the open operation rate significantly than traditional method did (P