Glisson蒂横断式肝切除术联合肝静脉导向在治疗肝胆管结石病的临床应用  

Clinical application of Glisson pedicle transverse hepatectomy combined with hepatic vein guidance in the treatment of hepatolithiasis

作　　者：淦勤 徐林龙 孙亭立[1] GAN Qin;XU Linlon;SUN Tingli(Department of hepatobiliary surgery,The First People's Hospital of Jiujiang,Jiangxi 332000,China)

机构地区：[1]江西省九江市第一人民医院肝胆外科,九江332000

出　　处：《江西医药》2021年第10期1628-1631,1644,共5页Jiangxi Medical Journal

基　　金：江西省卫生健康委科技计划项目,编号202120062。

摘　　要：目的探讨Glisson蒂横断式肝切除术联合肝静脉导向在治疗肝胆管结石病的临床应用效果。方法回顾性分析九江市第一人民医院肝胆外科2019年1月至2021年4月治疗的49例肝胆管结石患者的临床资料,其中Glisson蒂横断式肝切除术联合肝静脉导向治疗组(Glisson组)20例,Pringle法肝切除联合肝静脉导向治疗组(Pringle组)29例。对比两组在手术时间、术中出血量、围手术期输血率、结石清除率、术后肝功能变化情况、术后并发症发生率、术后住院时间等指标上的差异。结果两组患者在年龄、性别、肝硬化背景、肝功能分级、ECOG评分、手术时间、术中出血量、围手术期输血率、结石清除率及术后并发症发生率等指标上的差异无统计学意义(P>0.05);Glisson组术后住院时间短于Pringle组[(11.40±2.33)d vs(13.62±3.63)d],差异有统计学意义(P<0.05);术后第1、3、5、7d肝功能恢复均优于Pringle组,差异有统计学意义(P<0.05)。结论Glisson蒂横断式肝切除术联合肝静脉导向可以达到解剖性肝切除效果,且对比Pringle法,可缩短术后住院时间、不受阻断时间限制、更快的肝功能恢复,是一种简便且安全的手术方式。Objective To explore the clinical application effect of Glisson pedicle transverse hepatectomy combined with hepatic vein guidance in the treatment of hepatolithiasis.Methods A retrospective analysis of the clinical data of 49 patients with hepatolithiasis treated by the Department of Hepatobiliary Surgery,First People's Hospital of Jiujiang from January 2019 to April 2021.Among them,the Glisson pedicle transverse hepatectomy combined with hepatic vein guided therapy group(Glisson group)Of the 20 cases,29 cases were in the Pringle hepatectomy combined with hepatic vein guided therapy group(Pringle group).The differences in the operation time,intraoperative blood loss,perioperative blood transfusion rate,stone clearance rate,postoperative liver function changes,postoperative complications rate,postoperative hospital stay and other indicators were compared between the two groups.Results There was no statistical difference between the two groups of patients in indicators such as age,gender,liver cirrhosis background,liver function classification,ECOG score,operation time,intraoperative blood loss,perioperative blood transfusion rate,stone clearance rate,and postoperative complication rate.Clinical significance(P>0.05);the postoperative hospital stay in the Glisson group was shorter than that in the Pringle group[(11.40±2.33)d vs(13.62±3.63)d],the difference was statistically significant(P<0.05);The recovery of liver function at 3,5,and 7 days was better than that of the Pringle group,and the difference was statistically significant(P<0.05).Conclusion Glisson pedicle transverse hepatectomy combined with hepatic vein guidance can achieve the effect of anatomical liver resection,and compared with the Pringle method,it can shorten the postoperative hospital stay,free from the block time limit,and faster liver function recovery.It is a simple and convenient method.Safe operation method.

关 键 词：Glisson蒂 PRINGLE法 肝静脉 肝切除 肝胆管结石病 

分 类 号：R657.4[医药卫生—外科学]