腹腔镜下胆囊切除术中不同胆囊剥离方式的治疗效果分析  

Analysis of Therapeutic Effects of Different Gallbladder Dissection Methods in Laparoscopic Cholecystectomy

作　　者：杨懂理 YANG Dongli(Department of General Surgery,Yongqiao District Hospital of Traditional Chinese Medicine,Suzhou,Anhui 234000,China)

机构地区：[1]宿州市埇桥区中医院普外科,安徽宿州234000

出　　处：《生物医学工程学进展》2025年第1期109-114,共6页Progress in Biomedical Engineering

摘　　要：目的探讨腹腔镜下胆囊切除术中不同胆囊剥离方式的治疗效果,比较侧方入路剥离法与传统剥离法在手术指标、术后并发症及术后恢复方面的差异。方法对2021年1月至2023年11月在宿州市埇桥区中医院接受腹腔镜下胆囊切除术的80例胆囊结石患者的临床资料进行回顾性分析。将患者分为观察组(侧方入路剥离法,40例)和对照组(传统剥离法,40例)。对比两组手术时间、术中出血量、术后引流置管时间、术后引流量、术后并发症发生率、术后肠道功能恢复情况(肠鸣音恢复时间、肛门排气时间、排便时间)。结果①两组手术时间无显著差异[(71.23±4.82)min vs(69.75±4.65)min,P=0.166];观察组术中出血量显著低于对照组[(35.66±5.71)mL vs(40.03±6.34)mL,P=0.002];观察组术后引流置管时间明显短于对照组[(2.87±0.55)d vs(3.26±0.58)d,P=0.003];观察组术后引流量显著少于对照组[(46.55±7.13)mL vs(62.23±10.82)mL,P<0.001]。②两组术后并发症发生率差异无统计学意义(10.00%vs 15.00%,P=0.499)。③观察组肠鸣音恢复时间[(0.75±0.42)d vs(1.12±0.54)d,P=0.001]、肛门排气时间[(1.86±0.59)d vs(2.33±0.65)d,P=0.001]和排便时间[(2.78±0.65)d vs(3.15±0.73)d,P=0.019]均显著早于对照组。结论在腹腔镜下胆囊切除手术中,采用创新的侧方入路技术展现出多方面的临床优势,是一种安全、有效的胆囊剥离方式,值得在临床实践中推广应用。Objective To investigate the therapeutic effects of different gallbladder dissection methods during laparoscopic cholecystectomy and compare the outcomes between the lateral approach dissection method and the traditional dissection method in terms of surgical metrics,postoperative complications,and recovery.Methods A retrospective analysis was conducted on the clinical data of 80 patients with gallbladder stones who underwent laparoscopic cholecystectomy at Yongqiao District Hospital of Traditional Chinese Medicine from January 2021 to November 2023.The patients were divided into two groups:the observation group(lateral approach dissection method,40 cases)and the control group(traditional dissection method,40 cases).The two groups were compared regarding operative time,intraoperative blood loss,postoperative drainage tube duration,postoperative drainage volume,incidence of postoperative complications,and postoperative recovery indicators(time to bowel sounds recovery,time to first flatus,and time to first bowel movement).Results①There was no significant difference in operative time between the two groups[(71.23±4.82)min vs(69.75±4.65)min,P=0.166].The intraoperative blood loss in the observation group was significantly lower than that in the control group[(35.66±5.71)mL vs(40.03±6.34)mL,P=0.002];the postoperative drainage tube duration was significantly shorter in the observation group than that in the control group[(2.87±0.55)days vs(3.26±0.58)days,P=0.003];and the postoperative drainage volume was significantly less in the observation group than that in the control group[(46.55±7.13)mL vs(62.23±10.82)mL,P<0.001].②There was no statistically significant difference in the incidence of postoperative complications between the two groups(10.00%vs 15.00%,P=0.499).③The time to recovery of bowel sounds[(0.75±0.42)days vs(1.12±0.54)days,P=0.001],time to first flatus[(1.86±0.59)days vs(2.33±0.65)days,P=0.001],and time to first bowel movement[(2.78±0.65)days vs(3.15±0.73)days,P=0.019]were all significant

关 键 词：腹腔镜下胆囊切除术 侧方入路剥离 传统剥离 胆囊结石 术后恢复 并发症 

分 类 号：R454.4[医药卫生—治疗学]