腹腔镜与开腹手术切除残留胆囊病变的临床疗效研究  

Clinical study of laparoscopic cholecystectomy versus open cholecystectomy for residual gallbladder diseases

作　　者：吴涌宏[1] 温治强[1] 张耀明[1] Wu Yonghong et al(Department of Hepatobiliary Surgery, Meizhou People ＇s Hospital, Meizhou 514000, China)

机构地区：[1]广东省梅州市人民医院肝胆外二科,514000

出　　处：《齐齐哈尔医学院学报》2017年第14期1690-1692,共3页Journal of Qiqihar Medical University

摘　　要：目的探讨腹腔镜与开腹手术切除残留胆囊病变的治疗经验及疗效。方法选择2008年6月至2016年6月本院收治的30例胆囊切除术后残留胆囊的患者为研究对象,按手术方式分为研究组和对照组各15例,研究组行腹腔镜下残留胆囊病变再切除,对照组行开腹残留胆囊病变再切除。比较两组患者一般手术指标、临床疗效及并发症发生率。结果研究组患者术中出血量、排气时间和术后住院时间均显著低于对照组患者,需要止痛治疗的患者也显著低于对照组,差异有统计学意义(P<0.05)。两组患者手术时间和并发症发生率比较,差异无统计学意义(P>0.05)。两组患者术后均未出现残留胆囊病变和结石残留。研究组患者手术总有效率93.3%,高于对照组患者手术总有效率86.6%,差异无统计学意义(Z=-0.598,P=0.550)。结论腹腔镜手术治疗残留胆囊病变疗效可与开腹手术媲美,且具有微创的优势。Objective To summarize our experience of laparoscopic cholecystectomy versus open cholecystectomy for residual gallbladder diseases. Methods 30 patients underwent reintervention for residual gallbladder disease during June 2008 to June 2016 in our hospital. Of these patients, 8 cases received laparoscopic cholecystectomy while the others underwent open cholecystectomy as initial treatment. They were randomized into laparoscopic and open cholecystectomy for residual gallbladder disease. Operative data and postoperative outcome were analyzed. Results The amount of bleeding, exhaust time and postoperative hospital stay in the study group were significantly lower than those in the control group, and the patients who needed pain relief treatment were also significantly lower than the control group, the difference was statistically significant （ P〈 0.05）. There was no significant difference between the two groups in operation time and complication rate （P〉 0.05）. There were no residual gallbladder lesions and residual stones in the two groups after operation. The total effective rate of the patients in the study group was 93.3%, higher than that in the control group, and the total effective rate was 86.6%, and the difference was not statistically significant（ Z=-0.598, P= 0.550）. Conclusions The treatment effect of laparoscopic reintervention for residual gallbladder disease is equal to open surgery, and has the advantages of minimal invasion, worth clinical promotion.

关 键 词：腹腔镜 残留胆囊病变 开腹手术 

分 类 号：R575.62[医药卫生—消化系统]