术中可视化技术在肝内外胆管结石手术中的应用  

Application of intraoperative visualization technology in the operation of hepatolithiasis

作　　者：杜伟[1] 丁振[1] 安东[1] 王向阳[1] 胡可俊[1] DU Wei;DING Zhen;AN Dong(Department of hepatobiliary surgery,Chaohu Hospital of Anhui Medical University,Hefei 238000,China)

机构地区：[1]安徽医科大学附属巢湖医院肝胆外科,合肥238000

出　　处：《肝胆外科杂志》2022年第3期209-212,共4页Journal of Hepatobiliary Surgery

摘　　要：目的 探讨术中可视化技术在肝内外胆管结石手术中的应用。方法 回顾性分析2019年1月至2019年11月,安徽医科大学附属巢湖医院肝胆外科收治的22例肝内外胆管结石患者的临床资料,术前均诊断为肝内外胆管结石,运用术中可视化技术对肝内胆管结石进行实时探查,指导肝脏切除范围及术中取石,记录手术时间,手术并发症及术后残石率等相关数据。结果 所有患者手术均顺利完成,术中完全切除包含结石的肝叶或肝段,胆总管结石均一次性取尽,无结石残留。手术时间为(188.5±82.2)min,术中出血量为(320.5±62.6)ml,住院时间为(14.5±4.3)天,术后并发症主要为胆漏3例,发生率为13.6%(3/22),均给予通畅引流、保守治疗后好转出院,死亡率为0,术后残石率为0。结论 术中可视化技术能够优化肝内外胆管结石的手术方式,减少术后残石率的发生。Objective To explore the application of intraoperative visualization technology in the operation of hepatolithiasis.Method The clinical data of 22 patients with intrahepatic and extrahepatic cholelithiasis admitted to the Department of hepatobiliary surgery of Chaohu Hospital of Anhui Medical University from January 2019 to November 2019 were analyzed retrospectively. All patients were diagnosed as intrahepatic and extrahepatic cholelithiasis before operation. The intraoperative visualization technology was used to conduct real-time exploration of intrahepatic cholelithiasis, guide the scope of hepatectomy and intraoperative stone extraction, and record the operation time, operation complications and postoperative residual stone rate and other relevant data.Result All the patients were operated successfully. During the operation, the lobes or segments of the liver containing the stones were completely removed. All the stones in the common bile duct were removed at one time without any residual stones. The operative time was(188.5 ± 82.2) min, the intraoperative bleeding volume was(320.4 ± 62.6) ml, the hospitalization time was(14.5 ± 4.3) days, the postoperative complications were mainly bile leakage in 3 cases, the incidence was 13.6%(3/22), all patients were improved and discharged after unobstructed drainage and conservative treatment, the mortality was 0, and the residual stone rate was 0. Conclusion Intraoperative visualization technology can optimize the operation mode of hepatolithiasis and reduce the incidence of postoperative residual stones.

关 键 词：术中可视化技术 肝内外胆管结石 肝切除 残石率 

分 类 号：R657.4[医药卫生—外科学]