开腹胆囊切除术与腹腔镜胆囊切除术的比较研究

Balram Harsana, P. Jain
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引用次数: 0

摘要

研究目的本研究旨在评估腹腔镜胆囊切除术(LC)与开腹胆囊切除术(OC)在手术时间、失血量、术后不适、住院时间、成本效益和患者满意度方面的比较效果。研究还评估了死亡率、并发症和症状缓解等主要结果以及转换率、手术时间和恢复等次要结果的差异:我们在 2021 年 7 月至 2023 年 8 月期间在斋浦尔的索马尼医院开展了一项前瞻性观察研究,涉及 200 名年龄在 10-70 岁之间、通过超声波检查确诊为无症状胆结石的患者。患者被随机分配接受lC或OC手术。我们收集了手术时间、失血量、术后疼痛、住院时间和并发症等变量的数据。我们使用软件工具进行了统计分析:我们的研究涉及 200 名患者,主要为女性(77%)。lC患者的平均住院时间(2.8天)比OC患者(5.1天)短。从lC到OC的转换率为6%,主要是由于解剖和技术上的挑战。结论:与体外胆道手术相比,体外胆道手术效率更高、并发症更少、恢复更快、住院时间更短,因此符合条件的无症状胆石症患者首选体外胆道手术。较低的并发症发生率和较短的恢复时间表明,在可行的情况下,lC 应成为胆囊切除术的标准护理方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A COMPARATIVE STUDY BETWEEN OPEN CHOLECYSTECTOMY VERSUS LAPAROSCOPIC CHOLECYSTECTOMY
Objective: This study aims to evaluate the comparative effectiveness of laparoscopic cholecystectomy (LC) versus open cholecystectomy (OC) in terms of surgery duration, blood loss, postoperative discomfort, hospital stay length, cost-effectiveness, and patient satisfaction. It also assesses differences in primary outcomes, such as mortality, complications, and symptom relief, as well as secondary outcomes, including conversion rates, operative time, and recovery. Methods: We conducted a prospective observational study involving 200 patients aged 10-70 with symptomatic gallstones confirmed via ultrasonography at Somani Hospital, Jaipur, from July 2021 to August 2023. Patients were randomly assigned to undergo either lC or OC. We collected data on surgical duration, blood loss, postoperative pain, hospitalization period, and complications, among other variables. Statistical analysis was performed using software tools. Results: Our study involved 200 patients, predominantly female (77%). The average duration of lC was shorter (67.37 min) compared to OC (93.95 min). lC patients had a shorter average hospital stay (2.8 d) compared to OC patients (5.1 d). The conversion rate from lC to OC was 6%, primarily due to anatomical and technical challenges. Complications were significantly lower in lC (17%) compared to OC (28%). Conclusion: lC is more efficient, entails fewer complications, and leads to a quicker recovery and shorter hospital stay compared to OC, supporting its preference in surgical practice for eligible patients with symptomatic gallstone disease. The lower rate of complications and shorter recovery time suggest that lC should be the standard care for cholecystectomy where feasible.
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