Laparoscopic or Open Cholecystectomy in Patients with Sickle Cell Disease: which Approach is Superior?
作者:E. Leandros
DOI:10.1080/110241500447236
日期:2000.10.20
ObjectiveTo compare laparoscopic with open cholecystectomy in patients with sickle cell disease.DesignRetrospective clinical study.SettingUniversity hospital, Greece.Subjects41 patients (22 men and 19 women) with sickle cell disease had laparoscopic cholecystectomy between September 1991 and June 1998. Each patient was matched for age, sex, year of operation, and number of preoperative transfusions with control patients with sickle cell disease who had open cholecystectomy.Main outcome measuresDuration of operation, postoperative stay in hospital, incidence of complications, and conversion to open operation.ResultsThe mean operation time was 81.4 min (range 55–125) for open cholecystectomy and 64.2 min (range 45–90) for laparoscopic cholecystectomy (p < 0.01). Complications occurred in 5% (2/41) of the patients in the laparoscopic group and in 20% (8/41) of the patients in the open group (p = 0.04). The mean length of stay in hospital was 5.6 days (range 3–9) in the open group and 2.7 days (range 2–5) in the laparoscopic group (p < 0.01). Conversion to open operation was necessary in 2 (5%) patients.ConclusionsLaparoscopic cholecystectomy resulted in a shorter hospital stay with fewer postoperative complications than open operation in patients with sickle cell disease and may be the procedure of choice in the treatment of cholelithiasis in such patients.
目的:比较腹腔镜与开腹胆囊切除术在镰状细胞病患者中的应用。设计:回顾性临床研究。机构:希腊大学医院。对象:1991年9月至1998年6月,41名镰状细胞病患者(22名男性和19名女性)接受了腹腔镜胆囊切除术。每位患者与接受开腹胆囊切除术的镰状细胞病患者按年龄、性别、手术年份和术前输血次数进行匹配对照。主要结局指标:手术时间、术后住院时间、并发症发生率和转为开腹手术。结果:开腹胆囊切除术的平均手术时间为81.4分钟(范围55-125分钟),腹腔镜胆囊切除术的平均手术时间为64.2分钟(范围45-90分钟)(p < 0.01)。腹腔镜组5%(2/41)的患者和开腹组20%(8/41)的患者发生并发症(p = 0.04)。开腹组的平均住院时间为5.6天(范围3-9天),腹腔镜组的平均住院时间为2.7天(范围2-5天)(p < 0.01)。2名(5%)患者需要转为开腹手术。结论:在镰状细胞病患者中,腹腔镜胆囊切除术导致住院时间更短且术后并发症更少,可能是这类患者胆石症治疗的首选手术方式。