Abstract:

Objective

To explore the short-and medium-term efficacy of laparoscopic cholecystectomy （LC） via different approaches in the treatment of acute cholecystitis.

Methods

The clinical data of 150 patients with acute cholecystitis who underwent LC treatment from January 2022 to January 2024 were retrospectively analyzed.According to different surgical approaches，they were divided into the modified group and the traditional group.The traditional group underwent routine antegrade resection （n=75 cases），and the modified group underwent resection along the “A-B-D” approach （n=75 cases）.The statistical software SPSS 27.0 was used to process the data.Measurement data such as various perioperative indexes were expressed as （±s），and the independent sample t test was performed.Count data such as postoperative complications and the conversion rate to open surgery were expressed as［ cases （%）］，and the χ² test was used.A P value less than 0.05 was considered to indicate a statistically significant difference.

Results

The conversion rate to open surgery and the intraoperative bile duct injury rate in the modified group were （2.7%，2.7%） respectively，which were significantly lower than those in the traditional group （12.0%，13.3%） （P＜0.05）.There was no statistically significant difference in the incidence of abdominal cavity infection，bile leakage and bleeding between the two groups （P＞0.05）.The incidence of residual stones accompanied by cholecystitis in the modified group （2.7%） was significantly lower than that in the traditional group （13.3%） （P＜0.05）.

Conclusion

Compared with the routine antegrade resection，resection along the “A-B-D” approach can effectively reduce the bile duct injury rate，the conversion rate to open surgery and the incidence of residual stones accompanied by cholecystitis in LC patients.

Key words: Cholecystitis,Acute, Cholecystectomy,Laparoscopic, “A-B-D” Path, Conventional Anterograde Resection, Postoperative Complications