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Application effect of selective cholangiography in emergency laparoscopic cholecystectomy |
YIN Zhao-cheng YIN Yao-hua PENG Yan LIU Guo-sheng |
Department of General Surgery,Dongguan Qingxi Hospital in Guangdong Province,Dongguan 523660,China |
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Abstract ObjectiveTo investigate the clinical effect and safety of selective cholangiography (LOC)in emergency laparoscopic cholecystectomy.Methods Ninety-two patients with acute cholecystitis admitted into our emergency department of our hospital from April 2013 to April 2017 were selected as the study subjects,and they were divided into the observation group and control group according to the different surgical methods.Each group had 46 patients.Patients in the two groups were given laparoscopic cholecystectomy,in the observation group,LOC was given in laparoscopic cholecystectomy.Perioperative related indicators(operation time,the rate of transferring to laparotomy,intraoperative blood loss and hospital stay),postoperative complications(biliary tract injury,incision infection,residual stones in common bile duct,biliary tract infections,abdominal infection and postoperative syndrome)were compared in patients between the two groups.Results There was no significant difference in operative time,hospital stay,and the incidence of incision infection,biliary tract infection and abdominal infection between the two groups(P>0.05).In the observation group,the rate of transferring to laparotomy,the rate of biliary tract injury,residual stones in common bile duct and the incidence of postoperative syndrome were significantly lower than those of the control group,and intraoperative blood loss in the observation group was significantly fewer than that of the control group (P<0.05).Conclusion LOC in emergency laparoscopic cholecystectomy can effectively find triangular gallbladder trigonometry variation,such as the deputy right hepatic duct,variation of cystic duct inflow and so on,and it can effectively avoid the occurrence of iatrogenic biliary tract injury,reduce the rate of transferring to laparotomy and postoperative complications,reduce the incidence of residual stones to improve the quality of surgery to promote the rehabilitation of patients,clinical curative efficacy is good and the safety is high.It is worth promoting and applying in emergency laparoscopic cholecystectomy,especially in primary hospitals in clinic.
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