关键词: 胆囊良性疾病, 腹腔镜胆囊切除术, 侧方入路, 剥离胆囊

Abstract: Objective The aim of this study was to observe the clinical efficacy and safety of laparoscopic cholecystectomy (LC) in treatment of patients with benign gall bladder diseases. Methods 136 patients with benign gallbladder diseases were recruited in our hospital between January 2016 and January 2018, and all of them underwent LC. During the operation, the lateral approach to remove the gallbladder were conducted in 68 patients in group A, and the antegrade or retrograde approached to remove gallbladder were conducted in another 68 patients in group B. The post-operational pain was evaluated by visual analogue scales, and serum C-reactive protein (CRP),interleukin-6 (IL-6),neutrophil elastase (NE) and tumor necrosis factor-α (TNF-α) levels were assayed. Results The successful rates of operation in group A and in group B were 97.1% and 95.6%, and the conversion to open operation was 2.9% and 4.4%, respectively (P>0.05); 6 hours after operation, the VAS score in group A was (3.1±0.6), much lower than 【(4.1±1.0),P＜0.05】, and 12 hours after operation, the VAS score was (1.5±0.5), significantly lower than 【(3.1±0.7), P＜0.05】 in group B; after operation, serum CRP, IL-6, NE and TNF-α levels in group A were (2.9±1.3)mg/L, (3.3±0.7)ng/L, (1.2±0.5)μg/L and (0.9±0.7)ng/L, significantly lower than 【(4.2±1.6)mg/L, (4.8±1.5)ng/L, (2.6±0.9)μg/L and (1.9±0.8)ng/L, respectively,P<0.05】 in group B; at the end of three-month follow-up, the incidence of post-operational complications, such as gallbladder rupture or gallbladder bed exudation, in group A was 7.4%, much lower than 23.5% (P<0.05) in group B. Conclusions Laparoscopic cholecystectomy by through lateral approach to remove gallbladder might achieve satisfactory clinical outcomes, which could reduce trauma and post-operational complications.

Key words: Benign gallbladder diseases, Laparoscopic cholecystectomy, Lateral approach, Gallbladder stripping