腹腔镜肝切除联合胆道镜治疗肝内外胆管结石的临床研究  

Clinical research of laparoscopic hepatectomy combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones

作　　者：徐爱忠[1] 汪东树[1] 许国梁[1] 王磊[1] 高玲玲 程雪红 XU Ai-zhong;WANG Dong-shu;XU Guo-liang(Department of General Surgery,Anqing Hospital Af-filiated to Anhui Medical University,Anqing 246000,China)

机构地区：[1]安徽医科大学附属安庆医院普外科,安庆246000

出　　处：《肝胆外科杂志》2018年第4期274-277,共4页Journal of Hepatobiliary Surgery

摘　　要：目的观察并分析腹腔镜肝切除联合胆道镜治疗肝内外胆管结石手术的安全性、有效性。方法选取我院自2014年1月至2017年9月期间收治的40例肝内外胆管结石患者资料,根据手术方法不同入组,20例进行腹腔镜肝切除联合胆道镜探查的患者纳入观察组,20例进行开腹肝切除联合胆道镜探查的患者纳入对照组。针对两组患者的各项临床资料,分析其差异有无统计学意义。结果在手术时间、术中出血量方面,两组病例间的差异无统计学意义。两组患者术后第3天生化指标中,总胆红素的差异无统计学意义,谷丙转氨酶、前白蛋白、C-反应蛋白的差异有统计学意义。在术后住院时间、术后通气时间、术后第1天疼痛评分、术后第3天疼痛评分方面,两组患者间的差异有统计学意义。在并发症发生率、复发率方面,两组患者间的差异无统计学意义。结论治疗肝内外胆管结石,腹腔镜肝切除联合胆道镜是一种安全有效的手术方式,值得临床推广。Objective To observe and analyze the safety and effectiveness of laparoscopic hepatectomy combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones. Methods The data of 40 cases of intrahepatic and extrahepatic bile duct stones from January 2014 to September 2017 in our hospital were analyzed retrospectively. These patients were divided into different groups according to different surgical methods. The observation group （ n = 20 cases） underwent laparoscopic hepatectomy combined with choledochoseopy , while the control group （n = 20 cases） underwent open hepatectomy combined with eholedoehoscopy. We observed the clinical data of the two groups, and then analyzed whether the differences were statistically significant. Results The differences in the time of operation and the intraoperative bleeding between the two groups were not statistically significant. We com- pared the biochemical indexes at third days after operation between the two groups. The difference in total bilirubin was not statistically significant. The differences in alanine aminotransferase, prealbumin and C-reactive protein were statistically significant. The differ- ences in postoperative hospital stay, postoperative ventilation time, pain score at first days after operation, and pain score at third days after operation between the two groups were statistically significant. The differences in incidence of complications and recurrence rate were not statistically significant. Conclusions Laparoseopic hepatectomy combined with choledochoscopy is safe and feasible for the treatment of intraheDatic and extraheDatic bile duct stones. It＇ s worth oonularizing in the clinic.

关 键 词：腹腔镜肝切除术 肝内外胆管结石 胆道镜 

分 类 号：R657.4[医药卫生—外科学]