丝线结扎胆囊管+避离胆囊动脉腹腔镜胆囊切除术的临床研究  

Clinical research on laparoscopic cholecystectomy using the ordinary silk thread to ligate cystic duct and avoiding gallbladder artery

作　　者：王亚东 刘良超 王晓晖 吕承刚 程欣 屠佳 Wang Yadong;Liu Liangchao;Wang Xiaohui;Lv Chenggang;Cheng Xin;Tu Jia(Department of General Surgery,Wuhu Hospital of Traditional Chinese Medicine,Wuhu,Anhui241000,China)

机构地区：[1]芜湖市中医医院普外科,安徽芜湖241000

出　　处：《齐齐哈尔医学院学报》2023年第15期1408-1411,共4页Journal of Qiqihar Medical University

基　　金：安徽省芜湖市卫健委项目(WHWJ2021y052)。

摘　　要：目的探讨腹腔镜胆囊切除术(LC)中丝线结扎胆囊管+避离胆囊动脉的安全性和可行性。方法选择2019年8月—2021年8月本院收治的80例行LC术的患者进行回顾性分析。80例患者中,应用丝线结扎胆囊管及避离胆囊动脉行胆囊切除者40例作为观察组;常规使用钛夹行LC术者40例作为对照组。比较两组患者的术前焦虑、手术时间、胆囊三角处理时间、术中出血量、中转开腹、VAS评分、住院总时间及住院费用。结果比较两组患者焦虑分级,观察组无焦虑、轻度焦虑、中度焦虑及重度焦虑人数分别为14、21、4、1例、对照组分别为9、14、11、6例,两组间差异具有统计学意义(χ^(2)=9.06,P<0.05);观察组及对照组术中出血分别为(10.83±9.77)ml、(19.75±16.17)ml,组间对比差异有统计学意义(t=2.99,P<0.05),组间焦虑度[65.00%(26/40)、77.50%(31/40)]、手术时间[(75.55±25.94)min、(69.75±18.53)min]、胆囊三角处理时间[(75.55±25.94)min、(69.75±18.53)min]、中转开腹例数、VAS评分、住院总时间及住院费用比较,差异均无统计学意义(P>0.05)。结论LC术中丝线结扎胆囊管+避离胆囊动脉行胆囊切除安全可行,并在一定程度上能缓解患者术前焦虑、减轻患者经济负担,值得在临床推广。Objective To discuss the safety and feasibility of using the ordinary silk thread to ligate cystic duct and avoiding gallbladder artery in laparoscopic cholecystectomy(LC).Methods 80 patients who underwent LC in Wuhu hospital of traditional Chinese medicine from August 2019 to August 2021were analyzed retrospectively.Among the 80 patients,40 patients who underwent cholecystectomy using silk thread to ligate cystic duct and avoiding gallbladder artery were enrolled in the observation group;40 patients underwentLCconventionally using titanium clip were enrolled in the control group.Preoperative anxiety,operation time,gallbladder triangle treatment time,intraoperative blood loss,conversion to open surgery,VAS score,total length of staying in the hospital and total cost were compared between the two groups.Results The number of patients with no anxiety,mild anxiety,moderate anxiety and severe anxiety in the observation group were 14,21,4 and 1,and those in the control group were9,14,11 and 6 respectively,and the difference between the two groups was statistically significant(χ^(2)=9.06,P<0.05).The intraoperative bleeding of the observation group and the control group were(10.83±9.77)ml and(19.75±16.17)ml,respectively,and the difference between the two groups was statistically significant(t=2.99,P<0.05).There were no significant difference in intergroup anxiety[65.00%(26/40),77.50%(31/40)],operation time[(75.55±25.94)min(69.75±18.53)min],gallbladder triangle treatment time[(75.55±25.94)min(69.75±18.53)min],the number of cases transferred to open surgery,VAS score,total length of hospital stays and hospitalization cost between the two groups(P>0.05).Conclusions During LC,it is safe and feasible to perform cholecystectomy using the ordinary silk thread to ligate cystic duct and avoiding gallbladder artery,and it can relieve preoperative anxiety and economic burden of patients to a certain extent,which is worthy of clinical promotion.

关 键 词：腹腔镜胆囊切除术 丝线 胆囊动脉 

分 类 号：R459.9[医药卫生—治疗学]