不同入路行腹腔镜胆囊切除术在胆囊结石并慢性胆囊炎中的应用对比OA
Comparison of Laparoscopic Cholecystectomy by Different Approaches in The Treatment of Cholecystolithiasis Complicated with Chronic Cholecystitis
目的 对比胆囊结石合并慢性胆囊炎临床治疗中,经胆囊前三角入路与后三角入路行腹腔镜胆囊切除术(LC)的临床疗效及安全性.方法 选取胆囊结石合并慢性胆囊炎患者62例为研究对象,时间段为2018年1月至2024年12月,患者来源于鄂州市第三医院,均行LC治疗.分组方式依据手术入路不同,分为对照组与观察组.其中,对照组31例采取经胆囊前三角入路手术方式,观察组31例采取经胆囊后三角入路手术方式.对比干预效果.结果 观察组各项围术期指标显著优于对照组(P<0.05).观察组手术视野满意度明显高于对照组,中转开腹率显著低于对照组(P<0.05).观察组术后4 h、12 h、24 h视觉模拟评分法(VAS)评分、术后1 d、3 d血清C反应蛋白(CRP)、降钙素原(PCT)水平及并发症发生率均低于对照组(P<0.05).结论 对于胆囊结石合并慢性胆囊炎患者,在LC治疗中经胆囊后三角入路可优化手术操作效率,改善手术视野,减轻术后疼痛与炎症反应,降低并发症风险,促进患者快速康复,临床应用价值显著.
Objective:To compare the clinical efficacy and safety of laparoscopic cholecystectomy(LC)via the anterior trian-gle approach and the posterior triangle approach in the clinical treatment of gallbladder stones combined with chronic chole-cystitis.Methods:Sixty-two patients with gallbladder stones complicated with chronic cholecystitis were selected as the re-search subjects.The time period was from January 2018 to December 2024.They were all from the Third Hospital of Ezhou City and all underwent LC treatment.The grouping methods were divided into the control group and the observa-tion group based on different surgical approaches.Among them,31 cases in the control group underwent surgery via the anterior triangle approach of the gallbladder,and 31 cases in the observation group underwent surgery via the posterior tri-angle approach of the gallbladder.Compare the intervention effects.Results:The perioperative indicators of the observation group were significantly better than those of the control group(P<0.05).The satisfaction rate of the surgical field in the observation group was significantly higher than that in the control group,and the conversion rate to laparotomy was signif-icantly lower than that in the control group(P<0.05).The Visual Analogue Scale(VAS)scores at 4 h,12 h,and 24 h after surgery,the levels of serum C-reactive protein(CRP)and procalcitonin(PCT)at 1 day and 3 days after surgery,and the incidence of complications in the observation group were all lower than those in the control group(P<0.05).Con-clusion:For patients with gallbladder stones combined with chronic cholecystitis,the posterior triangle approach of the gall-bladder in LC treatment can optimize the efficiency of surgical operations,improve the surgical field of view,reduce post-operative pain and inflammatory responses,lower the risk of complications,and promote the rapid recovery of patients.The clinical application value is significant.
高勇;高天翔
鄂州市第三医院普外科,湖北 鄂州 436001鄂州市中心医院骨科,湖北 鄂州 436000
医药卫生
腹腔镜胆囊切除术胆囊结石慢性胆囊炎手术入路胆囊三角
Laparoscopic cholecystectomyGallstonesChronic cholecystitisSurgical approachGallbladder triangle
《生命科学仪器》 2026 (3)
68-70,3
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