腹腔镜下胆囊切除术联合经胆囊后三角解剖入路对胆囊炎患者临床疗效和安全性的影响

摘要/Abstract

摘要： 目的评估经胆囊后三角解剖入路在腹腔镜下胆囊切除术中的应用效果。方法研究样本为2020年1月至2023年1月本院收治的106例急性胆囊炎患者,随机分为对照组与观察组,各53例。对照组行经胆囊三角入路切除,观察组行经胆囊后三角入路切除。比较两组围术期指标、手术前后的炎症水平、疼痛介质、应激指标,记录并发症。结果观察组和对照组手术时间分别为(33.14±4.06)min、(48.83±5.73)min,术中出血量分别为(35.24±4.12)mL、(49.67±5.69)mL,观察组均低于对照组(P＜0.05);观察组肠鸣音恢复时间、首次排气时间、首次排便时间、首次进食时间分别为(12.06±2.03)h、(19.26±2.70)h、(35.32±4.01)h、(1.55±0.36)d,均短于对照组(P＜0.05);观察组术后疼痛介质水平、炎性因子水平和应激指标均低于对照组(P＜0.05);观察组和对照组并发症发生率分别为5.66%(3/53)和22.64%(12/53),观察组低于对照组(P＜0.05)。结论经胆囊后三角解剖入路更有助于胆囊炎患者术后恢复。

关键词: 急性胆囊炎, 腹腔镜手术, 胆囊后三角, 并发症

Abstract: Objective To evaluate the effectiveness of the posterior gallbladder triangle approach in laparoscopic cholecystectomy. Methods The study sample included 106 patients treated for acute cholecystitis from January 2020 to January 2023. Fifty-three patients were randomly assigned to each of two groups. All patients underwent laparoscopic cholecystectomy; the control group underwent the conventional gallbladder triangle approach, while the observation group used the posterior gallbladder triangle approach. Perioperative indicators were recorded. Levels of inflammatory markers, pain mediators, and stress response markers pre-surgery and 24 hours post-surgery were compared between the groups. Complications were also recorded. Results The surgical time for the observation group and the control group was (33.14±4.06) minutes and (48.83±5.73) minutes, respectively, with the observation group showing significantly less time than the control group (P<0.05). The intraoperative blood loss for the observation group and control group were (35.24±4.12) mL and (49.67±5.69) mL, respectively, with the observation group having significantly less blood loss (P<0.05). The recovery time of bowel sounds, first time to pass gas, first time to defecate, and first time to eat in the observation group were (12.06±2.03) hours, (19.26±2.70) hours, (35.32±4.01) hours, and (1.55±0.36) days, respectively, all of which were significantly shorter than those in the control group (P<0.05). The levels of postoperative pain mediators, inflammatory factors, and stress indicators were all lower in the observation group compared to the control group (P<0.05). The complication rates for the observation group and control group were 5.66% (3/53) and 22.64% (12/53), respectively, with the observation group having a significantly lower rate (P<0.05). Conclusion The use of the posterior gallbladder triangle approach in laparoscopic cholecystectomy can reduce surgical time and intraoperative blood loss, and accelerate postoperative recovery.

Key words: Acute cholecystitis, Laparoscopic surgery, Posterior gallbladder triangle, Complications

刘磊, 崔发强, 尹天英. 腹腔镜下胆囊切除术联合经胆囊后三角解剖入路对胆囊炎患者临床疗效和安全性的影响[J]. 肝脏, 2025, 30(10): 1419-1423.

LIU Lei, CUI Fa-qiang, YIN Tian-ying. The impact of laparoscopic cholecystectomy combined with posterior gallbladder triangle approach on clinical efficacy and safety in patients with cholecystitis[J]. Chinese Hepatolgy, 2025, 30(10): 1419-1423.

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