三种微创保胆取石术的临床研究分析  

Clinical analysis of three kinds of minimally invasive gallbladder preserving lithotomy

作　　者：刘玉翔 叶昱坪[2] 

机构地区：[1]郑州颐和医院,450047 [2]河南省肿瘤医院,郑州,450008

出　　处：《中国实用医刊》2017年第9期53-55,共3页Chinese Journal of Practical Medicine

摘　　要：目的 分析小切口微创保胆取石术、腹腔镜辅助微创保胆取石术及全腹腔镜下微创保胆取石术的临床疗效.方法 回顾分析2013年7月至2016年8月58例行微创保胆取石术患者的临床资料,其中小切口微创保胆取石术（A组）12例,腹腔镜辅助微创保胆取石术（B组）18例,全腹腔镜下微创保胆取石术（C组）28例.比较分析三组患者年龄、手术时间、术中出血量、术后肠蠕动恢复时间、住院时间、住院费用及术后结石复发情况.结果 A、B两组患者年龄、手术时间、术后肠蠕动恢复时间及住院费用等比较差异均有统计学意义（P〈0.05）,术中出血量及住院时间比较差异未见统计学意义（P〉0.05）;A、C两组患者年龄、手术时间、术中出血量、术后肠蠕动恢复时间、住院时间及住院费用等比较差异有统计学意义（P〈0.05）;B、C两组患者手术时间、术中出血量、住院时间时间及住院费用等比较差异有统计学意义（P〈0.05）,年龄及术后肠蠕动恢复时间等比较差异均有统计学意义（P〉0.05）;术后结石复发A、B、C组间比较差异未见统计学意义（P〉0.05）.结论 完全腹腔镜下微创保胆取石术具备术中出血少、对腹腔脏器损伤少、术后患者胃肠功能恢复较快、住院时间短的优点,但手术时间长,住院花费稍高.Objective To investigate the clinical efficacy of small incision minimally invasive gallbladder preservation, laparoscopic assisted minimally invasive gallbladder preservation and laparoscopic minimally invasive gallbladder preserving lithotomy.Methods The clinical data of 58 patients with minimally invasive gallbladder preserving surgery from July 2013 to August 2016 were retrospectively analyzed, among them, 12 cases of small incision minimally invasive gallbladder preservation （group A）, 18 cases of laparoscopic assisted minimally invasive gallbladder preserving lithotomy （group B）, 28 cases of laparoscopic cholecystectomy with total laparoscopic minimally invasive surgery （group C）.The data of age, operative time, intraoperative blood loss, postoperative intestinal peristalsis recovery time, hospitalization time, hospitalization expenses and stone recurrence of the three groups after operation were compared and analyzed.Results The differences of age, operative time, postoperative bowel recovery time and hospitalization expenses between group A and B were significant（P〈0.05）, the amount of bleeding and hospitalization time had no significant difference （P〉0.05）.The diffeences of age, operation time, amount of bleeding, the recovery time of intestinal peristalsis, hospitalization time and cost between group A and C were significant （P〈0.05）;The difference of operation time, intraoperative bleeding, hospitalization time and hospitalization expenses between group B and C were significant （P〈0.05）, the age and recovery time of intestinal peristalsis between group B and C were significant （P〉0.05）;the postoperative stone recurrence in group A, B and C had no significant difference （P〉0.05）.Conclusions Total laparoscopic minimally invasive gallbladder preserving lithotomy has the advantages of less intraoperative bleeding, less damage to abdominal organs, faster postoperative recovery of gastrointestinal function and shorter hospitalization time.

关 键 词：胆囊结石 腹腔镜 胆道镜 保胆取石术 微创治疗 

分 类 号：R657.42[医药卫生—外科学]