腹腔镜胆囊切除术中肝外胆管损伤预防和治疗效果分析  

Analysis of prevention and curative effect of extrahepatic bile duct injury in laparoscopic cholecystectomy

作　　者：朱海平 刘滨 杜永基 黎东伟[2] 

机构地区：[1]广东省东莞三局医院普通外科,广东东莞523710 [2]广东省东莞东华医院肝胆外科,广东东莞523110

出　　处：《中国医药科学》2017年第8期219-221,共3页China Medicine And Pharmacy

摘　　要：目的探究腹腔镜胆囊切除术(LC)中肝外胆管损伤预防和治疗效果。方法选取2007年7月~2016年7月收治的680例LC患者临床资料进行分析,将其中出现肝外胆管损伤患者64例按照不同治疗方式分为对照组(32例)和研究组(32例),对照组行常规修复,研究组行干预修复治疗,观察两组胆管损伤不同类型发生率、术后并发症发生情况以及生活质量评分。结果两组各损伤类型发生率无显著差异(P>0.05),其中横断性损伤发生率最高;研究组术后并发症总发生率3.12%显著低于对照组21.87%,比较差异具有统计学意义(P<0.05),研究组的各项生活质量评分一般健康(20.19±3.63)分、社会活动(21.08±2.79)分、心理健康(20.67±3.25)分及精力(19.93±4.22)分均较对照组高,比较差异均具有统计学意义(P<0.05)。结论实行LC治疗胆囊疾病患者术中出现肝外胆管损伤时进行及时处理能够有效降低术后并发症发生率,做好预防措施能够有效提高患者生活质量,缩短住院时间。Objective To explore the prevention and curative effect of extrahepatic bile duct injury in laparoscopic cholecystectomy （LC）. Methods The clinical data of 680 LC patients who were treated from July 2007 to July 2016 were analyzed. 64 patients with extrahepatic bile duct injury were divided into the control group （32 cases） and the study group （32 cases） according to different treatment methods. The control group was given routine repair while the study group was given intervention repair treatment. Incidence of different types of bile duct injury, occurrence of postoperative complications and quality of life score of two groups were observed. Results There was no significant difference in the incidences of different types of injury between two groups （P 〉 0.05）. The incidence of transection injury was the highest. The total rate of postoperative complications in the study group was 3.12%, significantly lower than that of the control group 21.87%. The difference was statistically significant （P 〈 0.05）. Quality of life scores such as scores of general health, social activities, mental health and energy in the study group were respectively （20.19 ± 3.63）, （21.08 ±2.79）, （20.67 ± 3.25） and （19.93 ± 4.22）, all higher than those in the study group （P 〈 0.05）. The comparative difference was statistically significant （P 〈 0.05）. Conclusion Timely treatment of extrahepatic bile duct injury occurring in laparoscopic cholecystectomy can effectively reduce the incidence of postoperative complications. Preventive measures can effectively improve the quality of life and shorten hospitalization stay.

关 键 词：腹腔镜胆囊切除术 肝外胆管损伤 预防 治疗 

分 类 号：R657.4[医药卫生—外科学]