Small Incision Cholecystectomy Style Applied Research At The Grassroots Level Hospitals

Objective:To contrast open cholecystectomy and mini-cholecystectomy in treating innocence gallbladder disease(cholecystolithiasis,gallbladder polypus,simple cholecystitis) in people's hospital of pingyao province, and approach the application value of mini-cholecystectomy in substrate hospital through comparision of operation state,postoperative recovery and postoperative complication.Method:our hospital have cured 637 cases innocence gallbladder disease(cholecystolithiasis,gallbladder polypus,simple cholecystitis) from August 2002 to December 2005.The cases all have identified diagnosis,operation procedure and pathology examination.They were divided into 3 groups according to course of disease and characteristic of case history:symptomless group:which are 191 cases and were mainly discovered in general investigation;chronic course of disease group:which are 280 cases and include unemergency hospitalization but recurrent attacks in the symptom;acute course of disease group:which are 166 cases and were operated in the hospital.Every group was divided Oc group and MC group according to different operative method.They have different condition in postoperative rehabilitation and postoperative complication.The observation index include operating time,blood volume,lying in bed tme,gastrointestinal tract functional recovery time,postoperating rest time,transfusion time,expense,use of paregoric,incision complication,retained calculus,incidence rate,organ trauma incidence rate,bile vessel trauma incidence rate.Measurement data was showed with X±S and statistics with t test,and observation index include operating time,blood volume,lying in bed tme,gastrointestinal tract functional recovery time,postoperating rest time,transfusion time,expense;Numeration data was statistics with x2 test,and observation index include use of paregoric,incision complication,retained calculus,incidence rate,organ trauma incidence rate,bile vessel trauma incidence rate.Result:MC group have little trauma ,little pain and low expend.Its blood volume,lying in bed tme,gastrointestinal tract functional recovery time,postoperating rest time,transfusion time,expense and use of paregoric were lower than OC group,but the complication of MC operative form is higher than OC form.In three group patients,the complication of the MC operative form in chronic course of disease were higher than symptomless group and acute course of disease group; and the incidence rate of MC form turning to OC form has significant deviation,and chronic course of disease group were more higher than symptomless group and acute course of disease group.Conclusion:MC,OC and LC have their indication respectively,and be refered to which is good and which bad.They can have good effect when we chose appropriated cases.MC form deserve to extend in the substrate hospital where have no laparoscopically,especially to innocence gallbladder disease patients who are absence of symptoms.For the chronic course of disease patients,MC form should be chose with discretion in order to avoid enhance of complication.