两种术式治疗左半肝内胆管结石的2年随访分析  

Two-year follow-up analysis of two surgical procedures in treating left hepatic bile duct stones

作　　者：王勇 彭鹏 邓如兵 陈文龙 付前广 杨培[3] Wang Yong;Peng Peng;Deng Rubing;Chen Wenlong;Fu Qianguang;Yang Pei(Department of General surgery,longquan the first people's hospital,west China hospital,Sichuan 610100,China;Department of Anesthesiology,The Second Affiliated Hospital of Soochow University,Jiangsu 215004,China;The hospital office,mianyang central hospital,Sichuan 621000,China)

机构地区：[1]华西医院龙泉第一人民医院普外科,610100 [2]苏州大学附属第二医院麻醉科,215000 [3]绵阳市中心医院院办,621000

出　　处：《中华普外科手术学杂志（电子版）》2020年第6期590-592,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：四川省卫生和计划生育委员会科研课题(17PJ146)。

摘　　要：目的分析两种术式治疗左半肝内胆管结石的2年随访结果。方法回顾性分析2016年9月至2018年1月三家医院收治的87例左半肝内胆管结石患者病例资料。根据不同术式分为两组,将接受腹腔镜左半肝切除术(LLH)的45例患者纳入LLH组,接受开腹左半肝切除术(OLH)的42例患者纳入OLH组。采用SPSS 24.0软件进行数据处理,手术相关指标、术后恢复情况等计量资料以(±s)表示,采用独立t检验;术后并发症等计数资料采用χ^2检验,P<0.05为差异具有统计学意义。结果LLH组手术时间、入肝血流阻断时间比OLH组长,下床活动时间、肛门排气时间、腹腔引流时间、住院时间比OLH组短,术中出血量、术中输血率、视觉模拟评分法(VAS)评分比OLH组低,差异均有统计学意义(P<0.05)。两组术后并发症总发生率、结石清除率、结石复发率比较,差异均无统计学意义(P<0.05)。结论与OLH相比,LLH治疗左半肝内胆管结石可有效减少术中出血,加快术后恢复进程,但两种术式术后并发症、结石清除及复发情况差异无统计学意义。Objective To investigate the 2-year follow-up results of patients with left hepatic bile duct stones treated by using two kinds of surgical methods.Methods A retrospective analysis was performed in 87 patients with left hepatic bile duct stones in three hospitals from September 2016 to January 2018.According to the surgical methods,45 patients who underwent laparoscopic left hepatectomy(LLH)were divided into the LLH group,and 42 patients who underwent open left hepatectomy(OLH)were divided into the OLH group.Statistical analysis were performed by using SPSS 24.0 software.Measurement data,such as operation-related indicators and postoperative recovery were expressed as,and were examined by using independent t test.Count data such as complications were expressed as percentage and were analyzed by usingχ^2 test A P value<0.05 was considered as statistically significant difference.Results In the LLH group,there were longer operation time and blocking time of blood flow than those in the OLH group,while with shorter time of ambulation,anal exhaust time,abdominal drainage time and hospitalization time,and with lower intraoperative blood loss,intraoperative blood transfusion rate and visual analogue scale(VAS)than those in the OLH group respectively(P<0.05).There was no significant difference in the total incidence of postoperative complications,stone clearance rate and stone recurrence rate between the two groups(P<0.05).Conclusion Compared with OLH,LLH treatment of left intrahepatic bile duct stones could effectively reduce intraoperative bleeding and promote the postoperative recovery,with similar postoperative complications,stone removal and recurrence rate.

关 键 词：胆结石 肝切除术 左肝蒂阻断 随访研究 疗效比较研究 

分 类 号：R65[医药卫生—外科学]