Clinical Effect of Laparoscopic Cholecystectomy in the Treatment of Acute Suppurative Cholecystitis in the Elderly

WANG Tao; ZHAO Yong; WEI Sheng

doi:10.14033/j.cnki.cfmr.2023.34.013

Abstract：Objective:To explore the clinical effect of laparoscopic cholecystectomy in the treatment of acute suppurative cholecystitis in the elderly.Method:The clinical data of 68 elderly patients with acute suppurative cholecystitis admitted to Wuxi Rehabilitation Hospital from January 2015 to October 2021 were retrospectively analyzed.They were divided into endoscopic group(n=38)and laparotomy group(n=30)according to different surgical methods.Laparoscopic cholecystectomy and open cholecystectomy were performed in endoscopic group and laparotomy group.Perioperative indexes,liver function and stress indexes before and 1 d after surgery,and complications were compared between the two groups.Result:The operation time and hospital stay in the endoscopic group were shorter than those in the laparotomy group,the first anal exhaust time and first defecation time were earlier than those in the laparotomy group,and the intraoperative blood loss volume and postoperative drainage volume were less than those in the laparotomy group,the differences were statistically significant(P<0.05).One day after surgery,the alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL)levels in the two groups were higher than those before surgery,the levels of ALT,AST and TBIL in endoscopy group were lower than those in laparotomy group,the differences were statistically significant(P<0.05).One day after surgery,the levels of superoxide dismutase(SOD)in the two groups were lower than those before surgery,and the levels of malondialdehyde(MDA)were higher than those before surgery,and the level of SOD in the endoscopy group was higher than that in the laparotomy group,and MDA was lower than that in the laparotomy group,the differences were statistically significant(P<0.05).The incidence of complications in endoscopy group was lower than that in laparotomy group,and the difference was statistically significant(P<0.05).Conclusion:The application of laparoscopic cholecystectomy in elderly patients with acute suppurative cholecystitis has the advantages of less trauma,less intraoperative blood loss volume,short hospital stay,fewer complications,and less damage to patients'liver function,which can reduce stress reaction and has high safety.