腹腔镜联合胆道镜下肝左外叶切除并胆道探查治疗肝内外胆管结石的临床研究  

Laparoscopy Combined with Choledochoscopy Under the Left Lateral Hepatic Lobectomy and Biliary Tract Exploration in the Treatment of Intrahepatic Bile Cuct Stones Clinical Research

作　　者：赵华[1] ZHAO Hua(Department of Hepatobiliary Surgery,Zhoukou City Central Hospital,Henan 466000,China)

机构地区：[1]河南省周口市中心医院,河南周口466000

出　　处：《航空航天医学杂志》2022年第1期8-11,共4页Journal of Aerospace medicine

摘　　要：目的比较腹腔镜联合胆道镜下肝左外叶切除并胆道探查与开放手术治疗肝左外叶胆管结石并胆总管结石的临床疗效。方法分析2015年6月—2019年6月行肝左外叶切除并胆总管切开取石术的临床资料,共50例患者,根据其手术形式将其分为腹腔镜联合胆道镜手术组(A组)与开腹手术组(B组)各25例。统计两组手术及术后恢复情况。记录两组手术时间、术中出血量、术后拔除胃管时间、开始进食时间、肛门开始排气时间、拔除腹腔引流管时间、住院时间。统计两组手术并发症发生率。结果腹腔镜联合胆道镜手术组及开腹手术组均顺利完成肝左外叶切除,胆囊切除,胆总管切开取石术。腹腔镜联合胆道镜手术组手术时间242.4±12.5 min,开腹手术组手术时间254.5±16.2 min,两组在手术时间上无显著性差异。在拔除腹腔引流管时间上也无显著性差异。但在术中出血量、开始进食时间、肛门开始排气时间、住院时间上均有显著性差异。术后合并切口感染、脂肪液化上有显著性差异。两组在术后均无腹腔内出血。腹腔镜联合胆道镜手术组出现1例胆漏,开腹手术组出现1例胆漏,均经充分引流后治愈。两组腹腔积液、胸腔积液上无显著性差异。结论腹腔镜联合胆道镜下肝左外叶切除并胆道探查术安全、有效,同时具有出血少、恢复快、住院时间短的特点。Objective To compare the clinical effects of laparoscopic combined choledochoscopy with left lateral hepatectomy with biliary exploration and open surgery in the treatment of bile duct stones and common bile duct stones in the left lateral lobe of the liver. Methods The data of left lobbectomy in Zhoukou Central Hospital from June 2015 to June 2019 were analyzed. A total of 50 patients were divided into laparoscopic combined choloscopic surgery group(A group) and 25 open abdominal surgery group(B group). Statistics of the operation and postoperative recovery of the two groups. The operation time, intraoperative blood loss, time to remove the gastric tube, time to start eating, time to start exhausting from the anus, time to remove the abdominal drainage tube, and hospital stay were recorded in the two groups. Statistics of the incidence of surgical complications in the two groups. Results The laparoscopic combined choledochoscopy group and the laparotomy group successfully completed the left lateral hepatic lobectomy, cholecystectomy, and choledocholithotomy. The operation time of the laparoscopic combined choledochoscopy group was 242.4±12.5 minutes, and the operation time of the laparotomy group was 254.5±16.2 minutes. There was no significant difference in the operation time between the two groups. There was no significant difference in the time to remove the abdominal drainage tube. However, there are significant differences in the amount of intraoperative blood loss, time to start eating, time to start exhaust from the anus, and length of hospital stay. There are significant differences in postoperative incision infection and fat liquefaction. Both groups had no intra-abdominal bleeding after surgery. One case of biliary leakage occurred in the laparoscopic combined choledochoscopy group and one case in the open surgery group, all of which were cured after adequate drainage. There was no significant difference in abdominal effusion and pleural effusion between the two groups. Conclusions Laparoscopy combin

关 键 词：肝胆管结石 腹腔镜手术 开放手术 并发症 

分 类 号：R657.42[医药卫生—外科学]