Timing of laparoscopic cholecystectomy for acute cholecystitis / 中国基层医药

ABSTRACT

Objective To explore the timing of laparoscopic cholecystectomy in patients with acute calculous cholecystitis.Methods The clinical data of 112 patients with acute calculous cholecystitis were divided into observation group and operation group.58 patients with the onset time distance operation time less than 72 h were assigned into observation group,54 patients with the onset time distance operation time ＞ 72h were assigned into control group.The situations of surgery,transit rate and postoperative complications were compared between the two groups.Results The operation time [(50.0 ± 10.3) min],anal exhaust time [(32.5 ± 1.2) h],postoperative pain time [(23.2 ± 2.3) h] and hospitalization time[(2.5 ±0.4)h] in the observation group were significantly shorter than those in the control group[(80.2 ± 15.1)min,(80.3 ±3.7)h,(55.6 ±2.5)h,(5.0 ± 1.6)d] (t =19.03,P =0.001;t =32.83,P =0.000;t =25.86,P =0.000;t =6.56,P =0.028).The observation group had 1 case of transit to laparotomy,the transit rate was 1.72％.The control group had 8 cases of transit to laparotomy,the transit rate was 14.81％.The transit rate of the observation group was lower than that of the control group,the difference was statistically significant (x2 =6.86,P =0.035).The observation group had 4 patients with bile leakage,the incidence rate of complication was 6.89％.The control group had 6 cases of bile leakage,5 cases of hepatic duct laceration,the incidence rate of complication was 20.37％.The incidence rate of complication of the control group was higher than that of the observation group,the difference was statistically significant (x2 =4.71,P =0.042).Conclusion Laparoscopic cholecystectomy has significant effect for patients with acute calculous cholecystitis at 72 hours after onset,and has good safety and it is worthy of clinical application.