循肝中静脉入路腹腔镜左半肝切除术治疗肝内胆管结石的临床疗效及对患者应激与炎症反应的影响  

Clinical efficacy of laparoscopic left hemi hepatectomy via middle hepatic vein approach in the treatment of intrahepatic bile duct stones and its effect on patients’stress and inflammatory response

作　　者：田野[1] 肖璇 曹晓飞[1] TIAN Ye;XIAO Xuan;CAO Xiaofei(Hepatobiliary Surgery Department of Taizhou People's Hospital,Jiangsu Taizhou 225300,China)

机构地区：[1]泰州市人民医院肝胆外科,江苏泰州225300

出　　处：《临床普外科电子杂志》2022年第3期76-79,共4页Journal of General Surgery for Clinicians(Electronic Version)

摘　　要：目的探讨循肝中静脉入路腹腔镜左半肝切除术治疗肝内胆管结石的疗效及其对患者应激与炎症反应的影响。方法选择2019年1月至2022年1月泰州市人民医院收治的肝内胆管结石者80例,以随机数字表法分为对照组(常规腹腔镜左半肝切除术治疗,n=40)与观察组(循肝中静脉入路腹腔镜左半肝切除术治疗,n=40),比较两组患者手术相关指标,检测术前、术后皮质醇、C反应蛋白及白介素-6水平评估机体应激与炎症反应状态,并统计分析两组患者并发症发生率。结果两组患者均顺利完成手术,两组患者手术时间、出血量、下床时间、排气时间、住院时间均无显著差异(P>0.05)。观察组患者术后皮质醇、C反应蛋白、白介素-6水平均低于对照组(P<0.05),并发症发生率低于对照组(P<0.05)。结论对肝内胆管结石予循肝中静脉入路腹腔镜左半肝切除术治疗安全有效,能减轻应激与炎症反应,并发症风险更低。Objective To investigate the efficacy of laparoscopic left hemi hepatectomy via middle hepatic vein approach in the treatment of intrahepatic bile duct stones and its effect on stress and inflammatory response.Method 80 patients with intrahepatic bile duct stones treated in Taizhou People's Hospital from January 2019 to January 2022 were randomly divided into control group(conventional laparoscopic left hemi hepatectomy,n=40)and observation group(laparoscopic left hemi hepatectomy via middle hepatic vein,n=40).The related indexes of the two groups were compared,and the preoperative and postoperative cortisol,serum The levels of C-reactive protein and interleukin-6 were used to evaluate the state of stress and inflammation,and the incidence of complications in the two groups was statistically analyzed.Result All the patients in the two groups successfully completed the operation.There was no significant difference between the two groups in operation time,bleeding volume,time out of bed,exhaust time and hospital stay(P>0.05).The levels of cortisol,C-reactive protein and interleukin-6 in the observation group were lower than those in the control group(P<0.05),and the incidence of complications was lower than that in the control group(P<0.05).Conclusion Laparoscopic left hemi hepatectomy through the middle hepatic vein is safe and effective in the treatment of intrahepatic bile duct stones,which can reduce stress and inflammatory reaction,and reduce the risk of complications.

关 键 词：肝内胆管结石 循肝中静脉入路 腹腔镜 左半肝切除 并发症 

分 类 号：R65[医药卫生—外科学]