"V"字形解剖入路在腹腔镜复杂胆囊切除术中的临床应用价值研究  

Study on the clinical application value of V-shaped anatomical approach in laparoscopic complex cholecystectomy

作　　者：白庆阳[1] 封凯[1] 黄燕东 侴丽鸿 Bai Qingyang;Feng Kai;Huang Yandong;Chou Lihong(Department of Tumor Surgery,the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010,China;Department of Ultrasound,the Third Worker Hospital of Baotou Steel,Baotou 014010,China)

机构地区：[1]内蒙古科技大学包头医学院第一附属医院肿瘤外科,014010 [2]包钢第三职工医院超声科,包头014010

出　　处：《国际外科学杂志》2021年第10期671-675,共5页International Journal of Surgery

基　　金：包头市医药卫生科技计划项目(2020Z1008-9)。

摘　　要：目的探讨"V"字形解剖入路在腹腔镜复杂胆囊切除术中预防胆道损伤及临床应用的价值。方法回顾性分析内蒙古科技大学包头医学院第一附属医院2020年6月—2021年6月收治的120例复杂胆囊切除术患者的病例资料,按照随机数字表法分为观察组与对照组,每组60例。所有患者均行腹腔镜胆囊切除术治疗,观察组行胆囊三角"V"字形解剖入路,对照组患者未用"V"字形解剖入路手术。对比两组患者手术情况、并发症与术后恢复情况。正态分布的计量资料用均数±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χ^(2)检验。结果观察组中转开腹率、术中出血量、手术时间分别为3.33%、(97.31±13.27)mL、(65.27±13.82)min,明显低于对照组的8.33%、(111.27±25.18)mL、(81.35±12.12)min,两组相比差异具有统计学意义(P<0.05);观察组胆道损伤发生率、并发症总发生率分别为0、8.33%,明显低于对照组的6.67%、28.33%,两组相比差异具有统计学意义(P<0.05);观察组术后排气时间、引流管留置时间、住院费用、住院时间分别为(9.89±3.58)h、(32.58±5.17)h、(3142.92±137.93)元、(4.73±1.42)d,明显低于对照组的(11.65±2.45)h、(46.18±6.49)h、(3424.29±156.34)元、(5.38±1.25)d,两组相比差异具有统计学意义(P<0.05)。结论对腹腔镜复杂胆囊切除术使用胆囊三角"V"字形解剖入路更有利于手术操作,能够减少患者手术时间与术中出血量,减少术中中转开腹率,降低手术胆道损伤等并发症发生率,促使患者早日康复,值得临床应用推广。Objective To investigate the"V",shaped anatomical approach in the prevention of bile duct injury during laparoscopic complex cholecystectomy and its clinical application value.Methods The patients with complex gallbladder from June 2020 to June 2021 in the First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology were selected as the research objects,and they were randomly divided into observation group and control group,with 60 cases in each group.All patients underwent laparoscopic cholecystectomy.The observation group underwent laparoscopic cholecystectomy through the triangle"7'shape of the gallbladder,and the control group did not use the"V"shape anatomy.The operation status,complications and postoperative recovery of the two groups of patients were compared.The measurement data of normal distribution were expressed by(Mean±SD),and t test was used for comparison between groups,and chi-square test was used for comparison between groups of count data.Results The conversion rate to laparotomy,intraoperative bleeding and operation time of observation group were 3.33%,(97.31±13.27)mL,(65.27±13.82)min,which were significantly lower than those in the control group[8.33%,(111.27±25.18)mL,(81.35±12.12)min],the differences between the two groups were statistically significant(P<0.05).The incidence of biliary injury,total incidence of complications of the obserxation group were 0,8.33%,which were significantly lower than those in the control group(6.67%,28.33%),the differences between the two groups were statistically significant(P<0.05).The postoperative exhaust time,drainage tube retention time,hospitalization cost and hospitalization time of the observation group were(9.89±3.58)h,(32.58±5.17)h,(3142.92±137.93)yuan,(4.73±1.42)d,and significantly lower than those in the control group[(11.65±2.45)h,(46.18±6.49)h,(3424.29±156.34)yuan,(5.38±1.25)d],the differences between the two groups were statistically significant(P<0.05).Conclusions For laparoscopic complex c

关 键 词：胆囊切除术 腹腔镜 治疗应用 解剖入路 胆道损伤 

分 类 号：R657.4[医药卫生—外科学]