Comparison of efficacy of different surgical procedures in treatment of acute cholecystitis combined with gallstone

doi:10.3877/cma.j.issn.1674-3946.2019.06.031.

Abstract

Abstract:

Objective

To study the efficacy of different surgical procedures in treatment of acute cholecystitis combined with gallstone and its influence on liver function and stress response.

Methods

164 patients with acute cholecystitis combined with gallstone who received surgery from May 2015 to December 2017 were retrospectively analyzed. All the patients were divided into 86 cases of open group and 78 cases of laparoscopic group by different surgical procedures. SPSS20.0 statistical software was adopted, the measurement data of gastrointestinal function, liver function and stress response indexes of the two groups were expressed by (±s), and compared with t test. The count data such as gender of the two groups, disease type were analyzed by chi square. The difference was statistically significant at P<0.05.

Results

The postoperative defecation time, recovery time of bowel sound, feeding time, anal exhaust time in laparoscopic group were lower than those in open group (P<0.05); The postoperative AST, TBIL, ALT, CRP, ACTH, IL-6, cortisol levels in two groups were higher than those before surgery (P<0.05), but laparoscopic group was lower than open group (P<0.05).

Conclusion

Laparoscopic cholecystectomy in treatment of acute cholecystitis combined with gallstone can promote recovery of postoperative gastrointestinal function, decrease the influence on liver function and stress response, which is worthy of clinical promotion.

Key words: Cholecystitis, acute, Cholecystolithiasis, Cholecystectomy, laparoscopic, Laparotomy, Comparative effectiveness research

Pinyi Zhou, Yong Zhou, Dawei Guo, Anni Dong. Comparison of efficacy of different surgical procedures in treatment of acute cholecystitis combined with gallstone[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(06): 643-645.

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References 16

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组别	例数	年龄(岁)	性别(例)	结石类型(例)	结石大小(cm)
组别	例数	年龄(岁)	男/女	单发/多发	结石大小(cm)
开腹组	86	42.8±9.7	41/45	47/39	0.7±0.5
腹腔镜组	78	42.3±9.5	36/42	43/35	0.6±0.3
t值	?	0.333	0.038	0.004	1.533
P值	?	>0.05	>0.05	>0.05	>0.05

组别	例数	年龄(岁)	性别(例)	结石类型(例)	结石大小(cm)
组别	例数	年龄(岁)	男/女	单发/多发	结石大小(cm)
开腹组	86	42.8±9.7	41/45	47/39	0.7±0.5
腹腔镜组	78	42.3±9.5	36/42	43/35	0.6±0.3
t值	?	0.333	0.038	0.004	1.533
P值	?	>0.05	>0.05	>0.05	>0.05

组别	例数	排便时间	肠鸣音恢复时间	进食时间	肛门排气时间
开腹组	86	44.9±6.6	22.4±3.2	48.7±8.2	26.9±3.4
腹腔镜组	78	26.5±4.7	13.1±3.3	30.6±7.9	16.8±3.5
t值	?	20.376	18.313	14.364	18.735
P值	?	<0.05	<0.05	<0.05	<0.05

组别	例数	排便时间	肠鸣音恢复时间	进食时间	肛门排气时间
开腹组	86	44.9±6.6	22.4±3.2	48.7±8.2	26.9±3.4
腹腔镜组	78	26.5±4.7	13.1±3.3	30.6±7.9	16.8±3.5
t值	?	20.376	18.313	14.364	18.735
P值	?	<0.05	<0.05	<0.05	<0.05

组别	例数	时间	AST(U/L)	TBIL( mol/L)	ALT(U/L)
开腹组	86	术前	32.8±9.2	15.6±3.9	26.9±10.2
开腹组	86	术后24 h	74.7±13.2^a	34.8±5.2^a	62.9±9.6^a
腹腔镜组	78	术前	33.4±9.5	15.3±4.2	27.5±11.3
腹腔镜组	78	术后24 h	33.2±5.4^a	17.6±3.1^a	29.7±4.3^a

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