不同入路腹腔镜胆道探查术治疗胆总管结石的效果比较  

Comparison of Different Approaches of Laparoscopic Common Bile Duct Exploration in Treating Common Bile Duct Stone

作　　者：韩娟 HAN Juan(Department of Surgery,Shangqiu Central Hospital,Shangqiu 476000,China)

机构地区：[1]商丘市中心医院外科,河南商丘476000

出　　处：《河南医学研究》2021年第27期5065-5067,共3页Henan Medical Research

摘　　要：目的对比不同入路腹腔镜胆道探查术(LCBDE)治疗胆总管结石(CBDS)的效果。方法回顾性分析2019年4月至2020年12月商丘市中心医院外科收治的100例完成LCBDE的CBDS患者临床资料,根据手术入路方式分为A组(行胆管途径入路,50例)与B组(行改良入路,50例)。记录并比较两组患者手术及恢复指标(术中出血量、胆总管缝合时间、胃肠道功能恢复时间、住院时间)。比较两组术前、术后3 d的体温、总胆红素(T-Bil)水平;随访3个月,记录患者并发症发生情况。结果B组术中出血量少于A组,胆总管缝合时间、胃肠道功能恢复时间及住院时间均短于A组,差异有统计学意义(P<0.05);术后3 d时,两组体温均高于术前,血清T-Bil水平均低于术前,且观察组低温低于对照组,差异有统计学意义(P<0.05);术后3 d时,两组血清T-Bil水平比较,差异无统计学意义(P>0.05);术后随访3个月,B组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论与胆管途径入路比较,行改良入路LCBDE治疗CBDS可减少患者术中出血量,缩短胆总管缝合时间,利于患者术后康复,且患者术后体温波动小,并发症少。Objective To compare the effect of laparoscopic common bile duct exploration(LCBDE)with different approaches in treating common bile duct stone(CBDS).Methods A retrospective analysis was conducted,and the clinical data of 100 patients with CBDS who completed LCBDE treated in the Department of Surgery,Shangqiu Central Hospital from April 2019 to December 2020 were collected.According to different surgical approaches,they were divided into group A(bile duct approach,50 cases)and group B(modified approach,50 cases).The operation and recovery indexes(intraoperative bleeding,common bile duct suture time,gastrointestinal function recovery time and hospitalization time)were recorded and compared in both groups.The body temperature and total bilirubin(T-Bil)levels before and after 3 days of operation were compared in both groups.The patients were followed up for 3 months,and their complications were recorded.Results Compared with group A,the amount of intraoperative bleeding was less,common bile duct suture time,gastrointestinal function recovery time and hospitalization time were shorter in group B(P<0.05).Compared with before operation,the body temperature was higher and the level of serum T-Bil was lower in both groups 3 days after operation,and compared with the control group,the hypothermia in the observation group was lower(P<0.05).There was no difference in comparison of serum T-Bil levels of both groups 3 days after operation(P>0.05).Followed up for 3 months after operation,compared with the control group,the incidence of complications in group B was lower(P<0.05).Conclusion Compared with the bile duct approach,the improved LCBDE approach in treating CBDS can reduce the amount of intraoperative bleeding,shorten the suture time of common bile duct,facilitate the postoperative rehabilitation of patients,and the postoperative temperature fluctuation of patients is small,with fewer complications.

关 键 词：胆总管结石 腹腔镜胆道探查术 改良入路 胆管途径入路 

分 类 号：R657.42[医药卫生—外科学]