SpyGlass系统在困难胆囊腹腔镜胆囊切除术中的应用价值  

Application value of SpyGlass System in laparoscopic cholecystectomy for difficult gallbladder

作　　者：刘炯 汪向飞 江斌 LIU Jiong;WANG Xiangfei;JIANG Bin(Department of Hepatobiliary and Pancreatic Surgery,Taihe hospital,affiliated to Hubei University of Medicine,Hubei Province,Shiyan City 444200,China)

机构地区：[1]湖北医药学院附属十堰市太和医院肝胆胰肝胆胰外科诊疗中心,444200

出　　处：《临床外科杂志》2023年第10期925-927,共3页Journal of Clinical Surgery

摘　　要：目的研究SpyGlass系统在困难胆囊腹腔镜胆囊切除术中的应用价值。方法2019年4月~2022年4月我院收治的困难胆囊腹腔镜胆囊切除术病人76例,采用随机数字表法分为实验组(38例)和对照组(38例)。对照组采用常规胆囊腹腔镜胆囊切除术,实验组采用SpyGlass系统指导下胆囊腹腔镜胆囊切除术。对比两组病人手术指标(手术时间、术中出血量、术中转开腹率)、临床指标(术后禁食时间、术后首次排气时间、下床活动时间);对比两组病人术后恢复情况以及并发症发生率。结果与对照组病人相比,实验组病人手术时间显著更短,术中出血量更少;对照组病人术中转开腹率为15.78%,实验组为2.63%,两组比较差异有统计学意义(P<0.05);与对照组比较,实验组病人术后禁食时间、术后首次排气时间和下床活动时间更短,差异有统计学意义(P<0.05);两组病人术后1天C反应蛋白和术后1天白细胞计数水平比较,差异无统计学意义(P>0.05);实验组病人并发症发生率为5.26%,对照组为15.78%,两组比较差异有统计学意义(P<0.05)。结论在困难胆囊腹腔镜胆囊切除术中的应用SpyGlass系统,能够缩短手术时间,降低术中出血量和术中转开腹率,并且术后恢复较快,安全性高。Objective To evaluate the application value of SpyGlass system in laparoscopic cholecystectomy for difficult gallbladder.Methods Seventy-six patients underwent laparoscopic cholecystectomy for difficult gallbladder in our hospital from April 2019 to April 2022 were enrolled,and patients were classified into two groups by random number table methods,each with 38 cases.Control group received routine laparoscopic cholecystectomy,while experimental group received laparoscopic cholecystectomy under SpyGlass system guidance.Then the operation indexes(operation time,intraoperative blood loss,rate of conversion to open surgery),and clinical indicators(postoperative fasting time,first postoperative exhaust time,out-of-bed activity time)were compared between two groups,meantime,the postoperative recovery and complication rate were also recorded in both groups.Results Experimental group had shorter operation time and less intraoperative blood loss than those of control group,with statistical difference(P<0.05).The rate of conversion to open surgery was 2.63%(1/38)in experimental group,which was lower than 15.78%(6/38)in control group,with statistical difference(P<0.05).Experimental group had decreased time to postoperative fasting,first postoperative exhaust and out-of-bed activity than control group,with statistical difference(P<0.05).The C-reactive protein(CRP)and white blood cell count(WBC)levels at postoperative 1 day yielded no statistical difference between two groups(P>0.05).The complication rate was 5.26%in experimental group,which was lower than15.78%in control group,with statistical difference(P<0.05).Conclusion Application of SpyGlass system in laparoscopic cholecystectomy for difficult gallbladder is effective and safe,which can effectively shorten the operation time,reduce the intraoperative blood loss,and decrease the rate of conversion to open surgery with good postoperative recovery in patients.

关 键 词：SpyGlass系统 胆囊切除术 腹腔镜 

分 类 号：R657.4[医药卫生—外科学]