腹腔镜手术在成人董氏C型胆管扩张症治疗中的疗效观察  

Efficacy of laparoscopic surgery on the treatment of Dong Type C adult biliary dilatation

作　　者：周松强[1] 白燕南[1] 田毅峰[1] 赖智德[1] 邱福南[1] 严茂林[1] 王耀东[1] Zhou Songqiang;Bai Yannan;Tian Yifeng;Lai Zhide;Qiu Funan;Yun Maolin;Wang Yaodong(Department of Hepatobiliary Surgery, Fujian Provincial Hospital, Fuzhou 350001)

机构地区：[1]福建省立医院肝胆外科福建医科大学省立临床学院,福州350001

出　　处：《国际外科学杂志》2019年第6期382-385,共4页International Journal of Surgery

基　　金：福建省卫生联合资金面上项目(2018J01250).

摘　　要：目的 探讨腹腔镜手术治疗成人董氏C型胆管扩张症的技术要点和疗效.方法 采用回顾性队列研究方法.收集2014年1月-2017年12月福建省立医院47例董氏C型成人胆管扩张症行手术治疗患者的临床资料,男性12例,女性35例;年龄范围16 ~68岁,中位年龄30岁.根据手术方式不同分为腔镜组(行腹腔镜胆总管囊肿切除及肝总管空肠Roux-en-Y吻合术,n=21)和开放组(行传统开放性手术,n=26).观察两组患者的术中出血量、并发症发生率、手术时间、术后肠道功能恢复时间及术后住院时间.正态分布的计量资料以均数±标准差(Mean±SD)表示,组间比较采用t检验;计数资料组间比较采用x2检验.结果 两组患者均无围手术期死亡.两组患者的术中出血量、并发症发生率差异均无统计学意义(P>0.05).腔镜组手术时间长于开放组,分别为(333.7±61.1) min和(235.9±64.3) min,差异有统计学意义(P=0.000);腔镜组的肠道功能恢复时间短于开放组,分别为(2.2±0.5)d和(2.9±0.6)d,差异有统计学意义(P=0.000);腔镜组的术后住院时间短于开放组,分别为(7.1±1.8)d和(12.0±5.9)d,差异有统计学意义(P=0.001).结论 腹腔镜手术治疗成人董氏C型胆管扩张症安全、可行,手术创伤小、恢复快.Objective To investigate the technical and therapeutic effects of laparoscopic surgery for adult patients with Dong Type C bile duct dilatation.Methods A retrospective cohort study approach was used.The clinical data of 47 patients with Dong Type C adult biliary dilatation who underwent surgery in Fujian Provincial Hospital from January 2014 to December 2017 were collected.There were 12 males and 35 females.The age ranged from 16 to 68 years,with a median age of 30 years.According to different surgical methods,the patients were divided into the laparoscopic group (treated with laparoscopic cyst excision and Roux-en-Y hepaticojejunostomy,n =21) and the open group (treated with traditional open operation,n =26).The intraoperative blood loss,complication rate,operation time,postoperative intestinal function recovery time and postoperative hospital stay were observed.Measurement data with normal distribution were expressed as mean ± standard deviation (Mean ±SD) and analyzed by t test.Comparison of count data was done by the chi-square test.Results There was no perioperative deaths in either group.There was no significant difference in intraoperative blood loss and complication rate between the two groups (P > 0.05).The operation time of the laparoscopic group was significantly longer than that of the open group[(333.7 ±61.1) min vs (235.9 ±64.3) min],with statistically significant difference between graps (P =0.000).The recovery time for the intestinal function of the laparoscopic group was significantly shorter than that of the open group [(2.2 ± 0.5) d vs (2.9 ± 0.6) d],with statistically significant difference between groups (P =0.000).The postoperative hospital stay in the laparoscopic group was significantly shorter than the open group [(7.1 ± 1.8) d vs (12.0 ± 5.9) d],with statistically significant difference between groups (P =0.001).Conclusion For adult biliary dilatation patiens with Dong Type C,laparoscopic surgery is safe and feasible with the advantages of mini-invasive and quick recovery.

关 键 词：腹腔镜 疗效比较研究 胆管扩张症 手术治疗 

分 类 号：R657.4[医药卫生—外科学]