再论胆囊切除手术术式与疗效的关系和比较

The Correlation and Comparison of the Operative Methods and Curative Effect in Gallbladder Surgery

摘要: 目的：总结经治158例结石性胆囊炎胆囊切除术手术治疗术式选择评价及其疗效比较分析。方法：对2006年07月至2014年12月作者经治的158例结石性胆囊炎等病例采用开腹胆囊切除术(Operate Cholecystectomy, OC，以下简称OC)或经腹腔镜胆囊切除术(Laproscopic Cholecystectomy, LC，以下简称LC)等两种不同手术方法进行手术治疗，并对开腹胆囊切除术(OC)与经腹腔镜胆囊切除术(LC)两种不同术式选择进行评价，并对其不同手术治疗方式的疗效进行比较分析。结果：采用OC与LC两种手术术式治疗结石性胆囊炎其术式选择及其疗效各有其优缺点、适应症及其禁忌症。结论：治疗结石性胆囊炎，常规选择术式有两种，即开腹胆囊切除术(OC)术式和经腹腔镜胆囊切除术(LC)术式。开腹胆囊切除术(OC)术式，其优点：主要是对病程长、疑难复杂的慢性病例较适用；缺点：对病人手术损伤相对较大，病人术后恢复相对较慢，住院时间相对较长，病人一般情况下不选择其作为胆囊切除术的首选术式。经腹腔镜胆囊切除术(LC)，其优点：主要是对病程短、单纯性的急性病例较适用，且术中损伤小，术后恢复较快，住院时间相对较短，一般病人要求作为胆囊切除术的首选术式；缺点：主要是手术器械较复杂且价格较昂贵，手术费用高；对于那些病程长、疑难复杂的慢性病例不适用；手术直观性差，术者不能用手直接触摸探查病灶特点、性质。

Abstract: The purpose of our research is to evaluate the difference of surgical options and compare the cur-ative effect by summarizing the treatment of 158 cases of cholecystitis cholecystectomy surgery. Methods: To evaluate the difference of open cholecystectomy (Operate Cholecystectomy, OC, he-reinafter referred to as OC) and laparoscopic cholecystectomy (Laproscopic Cholecystectomy, LC, hereinafter referred to as LC); to compare the curative effect of these two different operations, via summarizing the treatment of 158 cases of cholecystitis cholecystectomy surgery operated by the author from July 2006 to December 2006. Conclusion: There are two kinds of conventional selection operation for the treatment of calculous cholecystitis. One is open cholecystectomy (OC) operation, and the other is laparoscopic cholecystectomy (LC). Open cholecystectomy (OC) operation: its advantage is mainly applicable for longer duration and more difficult and complicated chronic cases. Disadvantages: Surgical injury to the patient is relatively large, the recovery of patients is relatively slow, hospital stay is relatively longer, and patient generally do not choose it as a cholecystectomy preferred surgical. Laparoscopic cholecystectomy (LC): Its advantages are mainly for short duration, simple acute cases are more applicable, intraoperative injury is small, postoperative recovery is faster, hospital stay is relatively short, and the average patient requires a gallbladder as the preferred surgical excision. Disadvantages: Surgical instruments are more complex and more expensive, the operation costs are high, and it’s not applicable for those long course and difficult complex chronic cases; the intuitive operation is poor, and the surgeon cannot directly touch probe lesions to check the characteristics and properties.