开腹手术与腹腔镜手术治疗先天性胆管扩张症的疗效对比  

Effects of conventional versus laparoscopic surgery in treatment of congenital bile duct dilatation: a comparative analysis

作　　者：陈厚斌[1] 黄伟[1] 

机构地区：[1]湖北省公安县人民医院肝胆外科,湖北公安434300

出　　处：《临床肝胆病杂志》2015年第6期951-954,共4页Journal of Clinical Hepatology

摘　　要：目的比较开腹手术和腹腔镜手术治疗成人先天性胆管扩张的临床治疗效果。方法回顾性分析2011年2月-2013年2月在湖北省公安县人民医院治疗的37例先天性胆管扩张症患者的临床资料。37例患者均进行胆管囊肿切除和肝总管空肠Roux-en-Y吻合手术,观察组为20例完全腹腔镜下手术患者,对照组为17例行传统开放手术患者。比较两组患者的平均手术时间、术中平均失血量、术后平均住院时间、术后平均排气时间、术后并发症。计量资料组间比较采用t检验,计数资料采用χ2检验。结果观察组的手术时间明显长于对照组,差异有统计学意义(P<0.05),但是观察组的术中平均失血量、术后平均住院时间、术后平均排气时间均少于对照组,差异具有统计学意义(P值均<0.05)。另外,两组患者手术后并发症组间差异无统计学意义(P>0.05)。结论与传统手术进行比较,在完全腹腔镜下对成人先天性胆管扩张患者进行胆管囊肿切除和肝总管空肠Roux-en-Y吻合手术,具有创伤小、安全性更高、恢复更快等优点,值得临床推广应用。Objective To compare the clinical effects of conventional versus laparoscopic surgery in adults with congenital bile duct dilatation. Methods A retrospective analysis was performed on the clinical data of 37 patients with congenital bile duct dilation who were treated in our hospital from February 2011 to February 2013. All the 37 cases underwent bile duct cyst resection and common hepatic duct- jejunal Roux- en- Y anastomosis; 20 of them（ study group） underwent laparoscopic surgery,while the other 17 cases（ control group） underwent open surgery. The mean operative time,mean intraoperative blood loss,mean length of hospital stay after surgery,mean time to first flatus after surgery,and postoperative complications were compared between the two groups. Comparison of continuous data between the two groups was made by t test,while comparison of categorical data was made by chi- square test. Results Compared with the control group,the study group had a significantly longer operative time（ P〈0. 05） but significantly less mean intraoperative blood loss,mean length of hospital stay after surgery,and mean time to first flatus after surgery（ P〈0. 05）. The incidence of postoperative complications showed no significant difference between the two groups（ P〈0. 05）. Conclusion Compared with conventional surgery,laparoscopic bile duct cyst resection and common hepatic duct- jejunal Roux- en- Y anastomosis is less invasive and safer and leads to faster recovery in adults with congenital bile duct dilation,and it is worthy of clinical application.

关 键 词：胆总管囊肿 胆道外科手术 腹腔镜检查 

分 类 号：R657.4[医药卫生—外科学]