完全腹腔镜下规则性左肝切除术治疗左肝胆管结石的临床研究  

Clinical study on total laparoscopic anatomical left hepatectomy in the treatment of left hepatolithi'asis

作　　者：贺德龙[1] 周为[2] 薛长梅 杨录[1] He Delong;Zhou Wei;Xue Changmei;Yang Lu(Surgical Department,Huangzhong Second People＇s Hospital of Qinghai Province,Xining Qinghai 811601;Hepatobiliary ＆ Gastroenterological Surgery,Qinghai University Affiliated Hospital,Xining Qinghai 810001)

机构地区：[1]青海省湟中县第二人民医院外科,西宁811601 [2]青海大学附属医院肝胆胃肠外科,西宁810001

出　　处：《中华普外科手术学杂志（电子版）》2018年第5期448-450,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨完全腹腔镜下规则性左肝切除术治疗左肝胆管结石的临床疗效。方法回顾性分析2013年8月至2017年2月收治的45例左肝胆管结石患者的临床资料,分别为腹腔镜组(21例)和开腹组(24例),采用SPSS 18.0软件进行统计学分析,围术期相关指标和肝功能指标等以(x±s)表示,采用独立样本t检验;术后白蛋白使用率、术中输血率、术后止痛药使用率、并发症发生率、结石清除率及复发率等组间比较采用χ2检验,P<0.05差异有统计学意义。结果腹腔镜组术中出血量、肛门排气时间、术后恢复饮食时间、术中输血率、术后止痛药使用率、白蛋白使用率及平均住院时间均明显优于开腹组,但手术时间明显长于开腹组(P<0.05);两组患者并发症发生率、结石清除率、复发率、治疗前后肝功能指标比较,差异均无统计学意义(P>0.05)。结论完全腹腔镜下规则性左肝切除术治疗左肝胆管结石是安全可行的,具有创伤小、疼痛轻、恢复快的优势,值得在临床推广应用。Objective To investigate the clinical efficacy of total laparoscopic anatomical left hepatectomy in the treatment of left hepatolithiasis. Methods The clinical data of 45 patients with left hepatolithiasis treated in our hospital from August 2013 to February 2017 were retrospective analyzed, including 21 cases in laparoscopic group and 24 cases in open group. Statistical analysis were performed by using SPSS 18.0 software, measurement data such as the perioperative indicators and liver function indexes were expressed as mean±standard deviation, and were examined by using t test. The postoperative usage of albumin, intraoperative blood transfusion rate, analgesic use rate, stone clearance rate, recurrence rate and postoperative complication rate were examined by using the Chi／｜square test. A P value of 〈0.05 was considered as significant difference. Results The operation time of the laparoscopic group was longer than that of the open group, intraoperative blood loss, postoperative anal exhaust time, diet recovery time, intraoperative blood transfusion rate, analgesic use rate, postoperative usage of albumin and average hospitalization time in the laparoscopic group were significantly better than those in the open group （P 〈0.05） ; No significant differences between the two groups were found in the postoperative complication rate, tone clearance rate and recurrence rate （ P〉0.05）. There was no significant difference of liver function indexes between the two groups before and after operation. Conclusion Total laparoscopic anatomical left hepatectomy in the treatment of left hepatolithiasis is feasible and safe, and has the benefits of small trauma, less pain, quick postoperative recovery, it is worthy of clinical promotion.

关 键 词：胆结石 腹腔镜检查 肝切除术 

分 类 号：R657.3[医药卫生—外科学]