不分离离断胆囊动脉主干的腹腔镜胆囊切除术治疗急性结石性胆囊炎的效果  

Effect of Laparoscopic Cholecystectomy without Separating the Disconnected Trunk of the Gallbladder Artery in the Treatment of Acute Calculous Cholecystitis

作　　者：王昆 陈勇 刘瑞 WANG Kun;CHEN Yong;LIU Rui(Suzhou Hospital of Traditional Chinese Medicine,Suzhou 234000,China;不详)

机构地区：[1]宿州市中医医院,安徽宿州234000

出　　处：《中外医学研究》2023年第13期52-55,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨不分离离断胆囊动脉主干的腹腔镜胆囊切除术治疗急性结石性胆囊炎(acute calculous cholecystitis,ACC)的效果。方法:回顾性选取2019年1月—2021年12月宿州市中医医院收治的110例行腹腔镜胆囊切除术治疗的ACC患者。根据不同手术方式将其分为观察组(n=50)和对照组(n=60)。对照组采用常规腹腔镜胆囊切除术,观察组采用不分离离断胆囊动脉主干的腹腔镜胆囊切除术。比较两组围手术期指标,术前及术后3 d胃功能、肠屏障功能及并发症。结果:观察组手术时间、住院时间均短于对照组,术中出血量少于对照组,肛门排气时间早于对照组,差异有统计学意义(P<0.05)。术后3 d,两组胃泌素(gastrin,GAS)、胃动素(motilin,MTL)水平均降低,但观察组GAS、MTL水平均高于对照组,差异有统计学意义(P<0.05)。术后3 d,两组肠型脂肪酸结合蛋白(intestinal fatty acid binding protein,IFABP)、D-乳酸水平均升高,但观察组IFABP、D-乳酸水平均低于对照组,差异有统计学意义(P<0.05)。观察组术后并发症发生率为6.00%,低于对照组的23.33%,差异有统计学意义(P<0.05)。结论:与常规腹腔镜胆囊切除术相比,不分离离断胆囊动脉主干的腹腔镜胆囊切除术治疗ACC患者效果更加显著,不仅能降低对胃功能的影响,减少并发症的发生,同时还能减轻肠屏障功能损伤。Objective:To explore the effect of laparoscopic cholecystectomy without separating the disconnected trunk of the gallbladder artery in the treatment of acute calculous cholecystitis(ACC).Method:A total of 110 ACC patients who underwent laparoscopic cholecystectomy in Suzhou Hospital of Traditional Chinese Medicine from January 2019 to December 2021 were retrospectively selected.According to different surgical methods,they were divided into observation group(n=50)and control group(n=60).The control group was treated with conventional laparoscopic cholecystectomy,and the observation group was treated with laparoscopic cholecystectomy without separating the disconnected trunk of the gallbladder artery.The perioperative indexes,gastric function,intestinal barrier function before and 3 d after operation and complications were compared between the two groups.Result:The operation time and hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the anal exhaust time was earlier than that of the control group,and the differences were statistically significant(P<0.05).Three days after operation,the levels of gastrin(GAS)and motilin(MTL)in the two groups were decreased,but the levels of GAS and MTL in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Three days after operation,the levels of intestinal fatty acid binding protein(IFABP)and D-lactic acid in the two groups were increased,but the levels of IFABP and D-lactic acid in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the observation group was 6.00%,which was lower than 23.33%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Compared with conventional laparoscopic cholecystectomy,the effect of laparoscopic cholecystectomy with

关 键 词：胆囊动脉 腹腔镜胆囊切除术 急性结石性胆囊炎 肠屏障功能 

分 类 号：R657.4[医药卫生—外科学]