腹腔镜下精准肝切除与非规则性肝切除治疗肝内胆管结石的效果及对肝功能的影响  

Curative effects of laparoscopic precise hepatectomy and irregular hepatectomy in treatment of intrahepatic bile duct stones and its effects on liver function

作　　者：邱金伦 廖锦岐[1] 游锦华[1] 李坤平[1] 廖方[1] QIU Jinlun;LIAO Jinqi;YOU Jinhua;LI Kunping;LIAO Fang(Department of Hepatobiliary Surgery,Huizhou First People’s Hospital,Huizhou 516000,China)

机构地区：[1]广东省惠州市第一人民医院肝胆外科

出　　处：《中国医药科学》2019年第19期209-212,共4页China Medicine And Pharmacy

摘　　要：目的探讨腹腔镜下精准肝切除与非规则性肝切除治疗肝内胆管结石的效果及对肝功能的影响。方法回顾性分析惠州市第一人民医院肝胆外科2014年1月~2018年12月收治的70例肝内胆管结石患者的临床资料,依据手术方法不同将以上研究对象分为PH组(精准肝切除)和IH组(非规则性肝切除),PH组40例,IH组30例,比较两组的临床疗效、手术时间、术中出血量、引流量、住院时间等围手术期指标、肝功能[总胆红素(TBIL)、谷丙转氨酶(ALT)、谷草转氨酶(AST)]及并发症情况。结果PH组的有效率(97.50%)显著高于IH组(73.33%)(P<0.05);PH组的手术时间显著长于IH组(P<0.05),术中出血量、引流量及住院时间显著少于IH组(P<0.05);PH组的TBIL、ALT及AST水平显著低于IH组(P<0.05);PH组的并发症发生率(5.00%)显著低于IH组(23.33%)(P<0.05)。结论腹腔镜下精准肝切除术相较于非规则性肝切除术治疗肝内胆管结石的临床效果更加显著,能够减少术中出血量,缩短住院时间,利于术后肝功能的恢复,且降低并发症发生率。Objective To explore curative effects of laparoscopic precise hepatectomy and irregular hepatectomy in treatment of intrahepatic bile duct stones and its effects on liver function.Methods The clinical data of 70 patients with intrahepatic bile duct stones who were admitted and treated in department of hepatobiliary surgery in Huizhou First People’s Hospital from January 2014 to December 2018 were retrospectively analyzed.According to the different surgical methods,the above research objects were divided into PH group(precise hepatectomy)and IH group(irregular hepatectomy),with 40 cases in PH group and 30 cases in IH group.The clinical curative effects,operative time,intraoperative blood loss,drainage volume,hospital stay and other perioperative indexes,liver function[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST)]and complications were compared between the two groups.Results The effective rate in PH group was significantly higher than that in IH group(97.50%vs 73.33%)(P<0.05).The operative time in PH group was significantly longer than that in IH group(P<0.05).The intraoperative blood loss,drainage volume and hospital stay were significantly less than those in IH group(P<0.05).The levels of TBIL,ALT and AST in PH group were significantly lower than those in IH group(P<0.05).The incidence rate of complications in PH group was significantly lower than that in IH group(5.00%vs 23.33%)(P<0.05).Conclusion Compared with irregular hepatectomy,laparoscopic precise hepatectomy in treatment of intrahepatic bile duct stones has more significant clinical curative effects.It can reduce intraoperative blood loss,shorten the length of hospital stay,benefit the recovery of postoperative liver function,and reduce the incidence of complications.

关 键 词：腹腔镜 精准肝切除 非规则性肝切除 肝内胆管结石 

分 类 号：R657.42[医药卫生—外科学]