小切口与腹腔镜胆囊切除术比较初探(附19例报告)

目的为探讨小切口胆囊切除术与腹腔镜胆囊切除术两术式的利弊.方法随机分小切口胆囊切除术组(MC)8例和腹腔镜胆囊切除术组(LC)11例.以术中所需时间(min)、术后肛门排气时间(h)、术后起床活动天数(d)、术后住院天数(d)、术后出现并发症和住院费用等指标比较.结果手术时间和术后住院日两组无明显差别.术后肛门排气LC(12～48h)先于MC(25～60h).术后起床活动MC当天7/8例先于LC第1天7/11例.平均住院费用MC(3900元)低于腹腔镜组(5200元).结论MC无需昂贵器械,对Calot三角区的操作比腹腔镜操作更具安全;手术误伤胆道等脏器,MC比LC更易于避免或及时发现处理;对机体的微创程度可与腹腔镜媲美,且费用低廉.故MC在基层医院更具扩大应用价值.

Comparative Study on Minicholecystectomy and Laparoscopic Cholecystectomy(Report of 19 Cases)

Objective Comparing the benefit and adverse of minicholecystectomy(MC) with laparoscopic cholecystectomy(LC) was studied.Methods Patients with cholelithiasis,chronic cholecystitis or gallbladder polypsis were randomly divided into MC(8 cases) and LC (11 cases). Compared MC with LC by the parameters of operating time(min),postoperative anus exhaust time(h),postoperative getting up for moving(d), postoperative hospitalization cost(yuan).Results There was no significant difference between MC and LC groups in operating time and postoperative hospitalization time. The postoperative anus exhaust time in LC was less than that in MC, and the average hospitalization cost in MC was lower than that in LC.Conclusion Performing of MC does not need expensive instrument and it is saver than LC during the operation in Calot triangle zone. Comparing with LC,MC is easier to avoid the accicential injury to biliary tract. The microinvasion to body is similar in both MC and LC and the cost of MC is less than LC. Thus MC is more appropriate to perform in basic hospitals.