谢世华++刘志文++周告生++郭昌文

[摘要] 目的 探讨腹腔镜逆行次全胆囊切除术治疗慢性结石性胆囊炎的临床效果。方法 选取我院2014年3月～2016年3月接收的慢性结石性胆囊炎患者86例，将其随机分为两组，每组43例。对照组采用腹腔镜逆行全胆囊切除术进行治疗，治疗组采用腹腔镜逆行次全胆囊切除术进行治疗。比较两组的治疗效果、出血量、手术时间、排气时间、下床活动时间、术后住院时间。结果 治疗组的總有效率为90.7%，明显高于对照组的69.8%（P<0.05）；治疗组的出血量明显少于对照组（P<0.05），手术时间、排气时间、下床活动时间、术后住院时间显著短于对照组（P<0.05）。结论 腹腔镜逆行次全胆囊切除术治疗慢性结石性胆囊炎具有良好的效果。

[关键词]腹腔镜逆行次全胆囊切除术；慢性结石性胆囊炎；治疗效果

[中图分类号] R575.6+1 [文献标识码] A [文章编号] 1674-4721（2017）06（b）-0039-03

[Abstract]Objective To discuss the clinical effect of laparoscopic retrograde subtotal cholecystectomy in the treatment of chronic calculous cholecystitis.Methods 86 patients with chronic calculous cholecystitis treated in the hospital from March 2014 to March 2016 were enrolled and they were randomly divided into two groups，and there were 43 cases in each group.The control group was treated with laparoscopic total cholecystectomy，while the treatment group was treated with laparoscopic subtotal cholecystectomy.The treatment effect，bleeding volume，operation time，exhaust time，ambulation time，postoperative hospital stay were compared between the two groups.Results The total effective rate in the treatment group was 90.7%，which was obviously higher than that of 69.8% in the control group （P<0.05）.The amount of bleeding in the treatment group was obviously less than that in the control group （P<0.05），and the operation time，exhaust time，ambulation time，postoperative hospital stay of the treatment group were significantly shorter than those of the control group （P<0.05）.Conclusion The laparoscopic retrograde subtotal cholecystectomy has a good effect in the treatment of chronic calculous cholecystitis.

[Key words]Laparoscopic retrograde subtotal cholecystectomy；Chronic calculous cholecystitis；Treatment effect

慢性结石性胆囊炎是常见病，主要由于结石引发胆囊炎症病变，给患者带来了巨大的痛苦。腹腔镜胆囊切除术是普通外科临床上常用的手术方式，具有创伤小、术后并发症少、术后恢复快等优势，已经逐渐取代传统手术在各种胆囊疾病患者中的地位，成为各类胆囊疾病外科手术治疗的首选方案[1-2]。近年来关于腹腔镜胆囊切除术在慢性结石性胆囊炎患者治疗中的优势研究较多，该手术方式微创的优点也不断得到临床医师和患者的一致认可[3-4]。但是腹腔镜逆行全胆囊切除术与腹腔镜逆行次全胆囊切除术在慢性结石性胆囊炎患者治疗中各自的优缺点尚需深入探讨和分析[5]。本研究将86例慢性结石性胆囊炎患者作为受试对象开展对照研究，比较两种手术的相关指标，旨在为临床治疗提供更理想的方案。……