Different Operative Methods For Treatment Of Acute Supp Urative Cholecystitis In Effect And Complications Analysis

Objective: Explore the traditional cystic resection, laparoscopic cholecystectomyand CT or ultrasound-guided percutaneous gallbladder colostomy drainage in thetreatment of acute suppurative cholecystitis the clinical curative effect of the three kindsof operation and the comparison of the postoperative complications, and discusses threecomplications of prevention and control measures.Methods: retrospective analysis in January,2009-jan.218were cases during acutesuppurative cholecystitis patients. According to the clinical and laboratory examinationand imaging diagnosis before, make different treatments, interventional therapy, wereused to open cystic resection and laparoscopic cholecystectomy treatment. Traditionalcystic resection in94patients (group A), the male38cases, female56cases).Laparoscopic cholecystectomy78cases (group B), the male30cases, female48cases;CT or ultrasound-guided percutaneous gallbladder colostomy drainage46cases (groupC), the male19cases, female27cases. Three groups of patients generally and medicalcomplications have no obvious difference (P>0.005). Observe and compare differentoperation scheme of the patients in the exhaust time, anti-infection treatment time andthe length of time the index; And in this observation or bile duct injury, whether havedamage, postoperative bleeding bowel, incision hernia and complications. Analysis ofthe cause and the postoperative complications treatment measures.Results: the three groups of patients with different surgical procedures,laparoscopic gallbladder resection and CT or ultrasound-guided puncture drainagegallbladder in gastrointestinal reduced pressure time, postoperative exhaust time,anti-infection treatment time and the mean hospital stay open cholecystectomy is weresignificantly reduced. Complications distribution: group A (n=94) the postoperativecomplications have: incision infection14cases (14.89%), abdominal bleeding in2cases(2.1%), biliary damage in5patients (5.32%), pylethrombosis5cases (5.32%); B group (n=74) the postoperative complications have: abdominal bleeding8cases (10.26%),transit open surgery18cases (23.08%), incision infection in2(2.56%), biliary damage15cases (15.38%), pylethrombosis13cases (16.67%); C group (n=46postoperativecomplications are:1case of incision infection (2.17%), pylethrombosis2cases (4.35%),abdominal bleeding1cases (2.17%), ma le surgery and biliary damage.Conclusion: open cholecystectomy safe, reliable, and symptoms, and indicationswide, but traumatic big, postoperative recovery slow, postoperative fasting time longfactors, so its current operation not only in the safety of a few laparoscopic wouldchoose to use. Laparoscopic cholecystectomy surgical technique is relatively complex,and part of the patients in the process to have open surgery may transfer, but the smalltrauma, postoperative recovery etc, and is currently in the clinical be the first choice. CTor ultrasound-guided percutaneous drainage by liver biopsy gallbladder is applicable topeople with severe basic diseases or intolerance to anesthesia and surgery patients, butpatients often need long-term indwelling the tube, serious impact on the quality of lifeof the patients. So usually need a second surgery to thoroughly cure the disease. So, sofar, for acute suppurative cholecystitis cases operation method, different methods eachhas his strong point, should according to the actual situation of different cases, executeindividual therapy.