腹腔镜下逆行全胆囊切除术与次全胆囊切除术治疗复杂胆管病变的效果对比研究  

Comparative Study on the Effect of Laparoscopic Retrograde Cholecystectomy and Subtotal Cholecystectomy in the Treatment of Complex Bile Duct Diseases

作　　者：张巍 单勇 李源 董毅 张锦洲 ZHANG Wei;SHAN Yong;LI Yuan;DONG Yi;ZHANG Jinzhou(The Second Department of General Surgery,Jinchang Central Hospital of Gansu Province,Jinchang,Gansu Province,737100 China)

机构地区：[1]甘肃省金昌市中心医院普外二科,甘肃金昌737100

出　　处：《中外医疗》2021年第24期62-64,共3页China & Foreign Medical Treatment

摘　　要：目的研究对比复杂胆管病变采用腹腔镜下逆行全胆囊切除术、次全胆囊切除术治疗的临床效果。方法方便选取2016年2月—2020年9月该院的120例复杂胆管病变患者为研究对象,采用随机数表法分成常规组和治疗组,每组60例。常规组予腹腔镜下逆行全胆囊切除术,治疗组予腹腔镜下逆行次全胆囊切除术。比较两组手术指标、并发症发生率。结果治疗组手术用时(87.20±9.58)min、术中失血量(100.06±22.13)mL、术中补液量(807.36±165.68)mL、腹腔引流量(131.89±32.45)mL低于常规组(107.95±11.16)min、(122.58±34.69)mL、(945.23±186.19)mL、(155.76±27.68)mL,差异有统计学意义(t=10.928、4.239、4.285、4.335,P<0.001);常规组并发症总发生率18.33%高于治疗组5.00%,差异有统计学意义(χ^(2)=5.175,P=0.023)。结论与腹腔镜下逆行全胆囊切除术相比,次全胆囊切除术用于复杂胆管病变治疗中手术时间更短、术中出血量更少,并发症发生率更低,建议进一步推广。Objective To study and compare the clinical effects of laparoscopic retrograde cholecystectomy and subtotal cholecystectomy for complex bile duct diseases.Methods From February 2016 to September 2020,120 patients with complex bile duct disease in the hospital were conveniently selected as the research objects,and they were divided into conventional group and treatment group by random number table method,with 60 cases in each group.The conventional group received laparoscopic retrograde total cholecystectomy,and the treatment group received laparoscopic retrograde subtotal cholecystectomy.The surgical indicators and the incidence of complications were compared between the two groups.Results The operation time(87.20±9.58)min,intraoperative blood loss(100.06±22.13)mL,intraoperative fluid supplement(807.36±165.68)mL,and abdominal drainage(131.89±32.45)mL in the treatment group were lower than those in the conventional group(107.95±11.16)min,(122.58±34.69)mL,(945.23±186.19)mL,(155.76±27.68)mL,the difference were statistically significant(t=10.928,4.239,4.285,4.335,P<0.001);the total incidence of complications in the conventional group was 18.33%higher than that in the treatment group 5.00%,the difference was statistically significant(χ^(2)=5.175,P=0.023).Conclusion Compared with laparoscopic retrograde total cholecystectomy,subtotal cholecystectomy for the treatment of complex bile duct lesions has shorter operation time,less intraoperative blood loss,and lower complication rate.It is recommended to be further promoted.

关 键 词：腹腔镜 并发症 胆管病变 全胆囊切除术 次全胆囊切除术 治疗效果 

分 类 号：R657.4[医药卫生—外科学]