三维腔镜系统在腹腔镜联合胆道镜胆囊取石术中的运用  

Application of three-dimensional laparoscopy for cholecystolithotomy combined with choledochoscopy

作　　者：许志营[1] 胡海[1] 徐安安[1] 何川琦[1] 吴连宝[1] 张凯[1] 焦龙[1] 张宇[1] 倪淑斌 叶芮琪[1] 

机构地区：[1]同济大学附属东方医院肝胆外科,上海200120

出　　处：《中华腔镜外科杂志（电子版）》2016年第4期221-223,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的探讨三维腔镜系统在腹腔镜联合胆道镜胆囊取石术中的优势。方法将2015年4月至10月同济大学附属东方医院肝胆外科行二维腹腔镜联合胆道镜胆囊取石术33例患者(二维组)与同期行三维腹腔镜联合胆道镜胆囊取石术30例患者(三维组)的临床资料进行对照研究,比较两组的手术时间、胆囊缝合时间、术中出血量等有无差异。结果两组手术均成功完成,63例患者中,二维组有3例、三维组有4例中转切胆术式(P>0.05),均无中转开腹患者。手术时间、胆囊缝合时间、术中出血量,二维组分别为(31.7±4.8)min、(14.2±3.0)min、(9.1±3.8)ml,三维组分别为(29.4±4.7)min、(11.7±2.4)min、(8.5±3.2)ml;两组的胆囊缝合时间比较,差异有统计学意义(P<0.05),手术时间、术中出血量比较,差异无统计学意义(P>0.05)。两组患者术后均随访6个月,无结石复发,无再次住院。结论三维腔镜系统在腹腔镜联合胆道镜胆囊取石术中安全、有效,在一定程度上可缩短胆囊缝合时间,提高胆囊缝合质量,降低手术难度,可作为腹腔镜联合胆道镜胆囊取石术的选择。Objective To investigate the advantage of three-dimensional （3D） laparoscopy in the treatment of cholecystolithotomy combined with choledochoscopy. Methods From Apr. to Oct. 2015, 33 patients underwent cholecystolithotomy by 2D laparoscopy combined with choledochoscopy （2D group） and 30 patients received 3D laparoscopic cholecystolithotomy （3D group） in the hepatobiliary surgery department of Shanghai East Hospital. The surgical data including the operative time,the time of gallbladder＇s suture and the intraoperative blood loss were compared between the two groups. Results 30 patients in 2D group and 26 patients in 3D group were successfully received the cholecystolithotomy by laparoscopy combined with choledochoscopy. 3 patients in 2D group and 4 patients in 3D group were converted to laparoscopic cholecystectomy （ P 〉 0. 05 ）. The time of gallbladder＇ s suture was significantly shorter in 3D group [（29.4 ± 4.7）min,（11.7 ± 2.4）min,（8.5 ± 3.2）ml] than in2D group[（31.7 ±4.8）min, （14.2 ±3.0）min, （9.1 ± 3.8）ml],[（11.7 ± 2.4） minvs （14.2 ± 3.0） min, P〈0.05）]. No significant differences were found in the operative time and the intraoperative blood loss between the two groups （ P 〉 0.05 ）. All patients were all followed up for 6 months postoperatively without stones recurrent and readmission. Conclusions 3D laparoscopic eholecystolithotomy combined with choledochoseopy is safe and effective. To a certain extent, it can shorten the time and improve the quality of the gallbladder suture, reduce the operation difficulty. Thus it will be a better choice for the treatment of cholecystolithotomy by laparoseopy combined with choledochoscopy.

关 键 词：三维 腹腔镜 胆道镜 胆囊取石 

分 类 号：R657.42[医药卫生—外科学]