腹腔镜左肝切除联合胆道镜治疗肝内胆管结石的效果分析  

Effect analysis of laparoscopic left hepatectomy combined with choledochoscope in the treatment of intrahepatic bile duct stones

作　　者：刘雷[1,2] 常加伟 贡庞君 李佳 LIU Lei;CHANG Jia-wei;GOING Pang-jun(The First Hospial of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学第一附属医院急诊外科,合肥230022 [2]安徽医科大学附属阜阳医院急诊外科

出　　处：《肝胆外科杂志》2023年第6期422-425,共4页Journal of Hepatobiliary Surgery

摘　　要：目的分析腹腔镜左肝切除与胆道镜联合应用对肝内胆管结石的临床治疗效果.方法选取2018年7月~2022年6月于安徽医科大学第一附属医院接受治疗的左肝内胆管结石患者96例,采取随机数字表法分为对照组及观察组,各48例,对照组采用开腹左肝切除联合胆道镜治疗肝内胆管结石,观察组施行腹腔镜左肝切除联合胆道镜治疗肝内胆管结石,比较两组治疗效果差异.结果观察组治疗总有效率高于对照组(P<0.05);观察组术中失血量、术后排气时间及住院时间等围术期指标数据均优于对照组(P<0.05);两组术后3d的CRP高于术前(P<0.05);观察组术后7d的GGT、ALT水平均低于对照组及术前(P<0.05);观察组术后7d的ALB水平高于对照组(P<0.05),但低于术前(P<0.05);观察组并发症发生率低于对照组(P<0.05).结论采取腹腔镜左肝切除联合胆道镜方案可使肝内胆管结石患者获得良好的临床治疗效果.Objective To analyze the clinical effect of laparoscopic left hepatectomy combined with choledochoscope in the treatment of hepatolithiasis.Methods From July 2018 to June 2022,96 patients with left hepatolithiasis were randomly divided into control group and observation group,48 cases in each group.The control group was treated with open left hepatectomy combined with choledochoscope,while the observation group was treated with laparoscopic left hepatectomy combined with choledochoscope.The ther-apeutic effects were compared between the two groups.Results The total effective rate of treatment was higher in the observation group than in the control group(P<0.05);Perioperative index data such as intraoperative blood loss,postoperative flatus time and hospital stay in the observation group were lower than those in the control group(P<0.05);CRP was higher in both groups 3 d after surgery than before(P<0.05);The levels of GGT and ALT in the observation group were lower than those in the control group and be-fore the operation(P<0.05);The alb level in the observation group was higher(P<0.05)than that in the control group at 7 d after surgery,but lower(P<0.05)than that before surgery;The complication rate of the observation group was lower than that of the con-trol group(P<0.05).Conclusion Laparoscopic left hepatectomy combined with choledochoscopy can achieve good clinical effect on intrahepatic bile duct stones.

关 键 词：腹腔镜 左肝切除 胆道镜 肝内胆管结石 临床效果 

分 类 号：R575[医药卫生—消化系统]