腹腔镜辅助与完全腹腔镜下保胆取石术治疗胆囊结石临床研究  

Laparoscopic Assisted and Totally Laparoscopic Cholecystolithotomy for Cholecystolithiasis

作　　者：上官昌盛 赵萍萍 向英 唐德涛 郑翔 杜胜霖 SHANGGUAN Chang-sheng;ZHAO Ping-ping;XIANG Ying;TANG De-tao;ZHENG Xiang;DU Sheng-lin(Department of General Surgery,the Second People's Hospital of Jingmen,Jingmen 448000,Hubei,China;Department of Oncology,the Second People's Hospital of Jingmen,Jingmen 448000,Hubei,China)

机构地区：[1]湖北省荆门市第二人民医院普通外科,荆门448000 [2]湖北省荆门市第二人民医院肿瘤科,荆门448000

出　　处：《中国现代手术学杂志》2018年第5期342-345,共4页Chinese Journal of Modern Operative Surgery

基　　金：荆门市科技一般项目(YFYB2017016)

摘　　要：目的比较腹腔镜辅助保胆取石术与完全腹腔镜下保胆取石术治疗胆囊结石的临床疗效。方法选取2015年9月～2016年9月我科收治的95例胆囊结石患者,随机分为两组,其中48例行完全腹腔镜下保胆取石术(实验组),47例行腹腔镜辅助保胆取石术(对照组)。比较两组手术相关指标、胆囊收缩功能及血清炎性因子变化情况。结果实验组术中出血量、手术时间及术后胃肠功能恢复时间均少于对照组,术后1月、6月及12月的胆囊功能明显优于对照组(P <0. 05)。两组术后1d Hs-CRP、IL-6和TNF-α水平均显著高于术前,对照组术后5 d三项指标亦显著高于术前(P <0. 05),实验组术后1 d和术后5 d均显著低于对照组(P <0. 05)。结论腹腔镜辅助与完全腹腔镜下保胆取石术治疗胆囊结石均是安全可行的手术方式,而后者更有助于术后胆囊功能恢复,对患者手术创伤及机体各项炎性因子影响更小,值得临床推广应用。Objective To compare the clinical efficacy of laparoscopic assisted and total laparoscopic cholecystolithotomy for gallstone. Methods A total of 95 cases with gallbladder stone in our department from September 2015 to September 2016 were randomly divided into two groups.Of which,48 cases were treated by total laparoscopic cholecystolithotomy(as the experimental group)and 47 cases were treated by laparoscopic assisted cholecystolithotomy(as the control group).The operation indexes,gallbladder contraction function and serum inflammatory factors were compared between the two groups. Results The amount of intra-operative bleeding,the operation time and the recovery time of gastrointestinal function were remarkable lower,and the gallbladder function of 1-,6-and 12 months after the operation was obviously better in the experimental group than those in the control group,and there were statistical differences between the two groups(P<0.05).The levels of Hs-CRP,IL-6 and TNF-alpha of both groups 1-day after the operation were significantly higher than those before the operation,the three indexes of the control group 5-days after the operation were obviously higher than those before the operation,and all three indexes of experimental group were remarkable lower at the time of 1-and 5-days than those of the control group,and all differences were statistically(P<0.05). Conclusion Both laparoscopic assisted and totally laparoscopic cholecystolithotomy are the safe and feasible surgical intervention for cholecystolithiasis,while the latter would be worthy of generalization with benefit to restore the gallbladder contraction function,less influence of surgical trauma and inflammatory factors.

关 键 词：胆囊结石病 腹腔镜检查 胆囊切开取石术 

分 类 号：R657.42[医药卫生—外科学]