腹腔镜胆囊次全切除术在困难性胆囊切除中的应用研究  

Application of Laparoscopic Subtotal Cholecystectomy in Difficult Cholecystectomy

作　　者：杨文艺[1] 黄志耿 黄黄叶 YANG Wenyi;HUANG Zhigeng;HUANG Huangye(Puning Overseas Chinese Hospital,Puning 515300,China;不详)

机构地区：[1]普宁华侨医院,广东普宁515300

出　　处：《中外医学研究》2023年第26期137-140,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：2021年度揭阳市医学科研项目(2021.158号)。

摘　　要：目的:观察腹腔镜胆囊次全切除术在困难性胆囊切除中的临床效果及安全性。方法:选择2019年2月—2021年2月普宁华侨医院收治的160例困难性胆囊切除患者,随机分为对照组和观察组,各80例。对照组采用腹腔镜胆囊切除术治疗,观察组采用腹腔镜胆囊次全切除术治疗,比较两组术中情况、术后恢复情况及并发症发生情况。结果:观察组手术时间、术后排气时间、恢复饮食时间、术后引流时间及住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。观察组术中2例中转开腹,中转开腹率为2.50%,对照组9例中转开腹,中转开腹率为11.25%,观察组中转开腹率低于对照组,差异有统计学意义(χ^(2)=4.783,P=0.029)。观察组并发症发生率为4.23%,低于对照组的14.10%,差异有统计学意义(P<0.05)。结论:腹腔镜胆囊次全切除术可降低手术难度,更有利于术中操作,提高术中的安全性,适宜于在困难性胆囊切除中应用。Objective:To observe the clinical effect and safety of laparoscopic subtotal cholecystectomy in difficult cholecystectomy.Method:A total of 160 patients with difficult cholecystectomy admitted to Puning Overseas Chinese Hospital from February 2019 to February 2021 were randomly divided into control group and observation group,with 80 patients in each group.The control group was treated with laparoscopic cholecystectomy,and the observation group was treated with laparoscopic subtotal cholecystectomy.The intraoperative conditions,postoperative recovery and complications of the two groups were compared.Result:The operation time,postoperative exhaust time,dietary restoration time,postoperative drainage time and hospitalization time in the observation group were all shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,the differences were statistically significant(P<0.05).In the observation group,a total of 2 cases were converted to laparotomy,and the conversion rate was 2.50%;in the control group,a total of 9 cases were converted to laparotomy,and the conversion rate was 11.25%;the conversion rate in the observation group was lower than that in the control group,the difference was statistically significant(χ^(2)=4.783,P=0.029).The incidence of complications in the observation group was 4.23%,which was lower than 14.10%in the control group,and the difference was statistically significant(P<0.05).Conclusion:Laparoscopic subtotal cholecystectomy can reduce the difficulty of the operation,is more conducive to intraoperative operation,and improve the safety of the operation,and is suitable for the application of difficult cholecystectomy.

关 键 词：腹腔镜 胆囊次全切除术 困难性胆囊切除 腹腔镜胆囊切除术 并发症 

分 类 号：R657.4[医药卫生—外科学]