后三角入路联合钝性冷分离在腹腔镜胆囊切除术中的临床效果  

Clinical Effect of Posterior Triangle Approach Combined with Blunt Cold Separation in Laparoscopic Cholecystectomy

作　　者：何聃 HE Dan(Department of Surgery,Pingba Hospital of Guihang,Anshun 561100,China)

机构地区：[1]贵航平坝医院外科,贵州安顺561100

出　　处：《中国医学创新》2025年第12期111-114,共4页Medical Innovation of China

摘　　要：目的:探究后三角入路联合钝性冷分离在腹腔镜胆囊切除术中的效果及预防胆管损伤的效果。方法:选取贵航平坝医院2022年12月—2024年12月接收的140例实施腹腔镜胆囊切除术患者作为研究对象。采用电脑随机抽签的方式将患者分为观察组与对照组,每组70例。观察组采用后三角入路联合钝性冷分离,对照组行常规胆囊三角入路,比较两组的预后情况。结果:观察组手术时间、住院时间均短于对照组,术中失血量少于对照组,胃肠功能恢复时间早于对照组,差异均有统计学意义(P<0.05)。术后3 d,观察组C反应蛋白(CRP)、白细胞介素-6(IL-6)及D-乳酸水平均较对照组低,差异均有统计学意义(P<0.05)。观察组术后胆管损伤等并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论:在腹腔镜胆囊切除术中采用后三角入路联合钝性冷分离能够在保证手术效果的基础上降低手术创伤并预防胆管损伤等并发症的发生。Objective:To explore the effect of posterior triangular approach combined with blunt cold separation in laparoscopic cholecystectomy and the prevention of bile duct injury.Method:A total of 140 patients who underwent laparoscopic cholecystectomy in Pingba Hospital of Guihang from December 2022 to December 2024 were selected as the research objects.Patients were randomly divided into observation group and control group by computer lottery,with 70 cases in each group.The observation group was treated by posterior triangle approach combined with blunt cold separation,while the control group was treated by conventional gallbladder triangle approach.The prognosis of the two groups was compared.Result:The operation time and hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the gastrointestinal function recovery time was earlier than that of the control group,the differences were statistically significant(P<0.05).3 days after surgery,the levels of C reactive protein(CRP),interleukin-6(IL-6)and D-lactic acid in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications such as bile duct injury in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Using posterior triangle approach combined with blunt cold separation in laparoscopic cholecystectomy can reduce surgical trauma and prevent complications such as bile duct injury on the basis of ensuring the surgical effect.

关 键 词：腹腔镜胆囊切除术 后三角入路 钝性冷分离 胆管损伤 

分 类 号：R657.4[医药卫生—外科学]