摘要
对2012年6月至2014年10月48例经超声、磁共振胰胆管造影确诊的胆总管结石患者按数字法随机分为2组，每组各24例。常规组患者行常规腹腔镜胆总管探查手术，手术者位于患者左侧完成手术；改良组操作者在术中适时地由患者左侧转移至患者右侧，主操作孔由剑突下戳孔转换为右腋前线戳孔，利用右侧2个操作孔进行胆总管缝合。结果显示，48例患者均在腹腔镜下完成了胆总管切开探查取石术，两组患者平均胆总管缝合时间[（13．6±2．5）min比（7．6±2．7）min，t=11．365，P=0．000]、术中出血量[（77．52±12．49）ml比（74．91±13．66）ml，t=2．627，P=0．008]、术后3d内最高体温平均值[（38．6±0．5）℃比（37．4±0．5）℃，t=9．954，P=0．000）]、术后平均住院时间（9．2±3．4）d比（7．1±2．1）d，t=8．730，P=0．000]比较，差异均有统计学意义。提示，与常规组相比，改良组患者所用胆总管缝合时间明显缩短，术后最高体温平均值明显减低，并发症明显减少；腹腔镜主操作孔转换在腹腔镜胆总管探查术胆总管缝合中具有灵活、方便、适用优点。
During June 2012 to October 2014, a total of 48 patients with stones in common bile duct diagnosed by ultrasound and magnetic resonance cholangiopancreatography （MRCP） were randomly divided into two groups （n =24 each）. The general group underwent conventional common bile duct exploration by laparoscopy （LCHTD） at left side. For improvement group, the operator timely transfered from left side to right side during laparoseopy. And two auxiliary holes of fight side were used for suturing common bile duct. All patients successfully completed common bile duct exploration by laparoscopy. The suturing times of common bile duct were （13.6 ±2.5） ＆ （7.6±2.7） min （t = 11. 365, P =0.000）, intraoperative bleeding volume （77.52 ± 12.49） ＆ （74.91 ± 13.66） ml （t =2.627,P =0.008）, average peak temperature at day 3 post-operation （38.6±0. 5） ＆ （37.4 ±0. 5）℃ （t =9. 954, P =0. 000） and average postoperative hospitalization length （9.2± 3.4 ） ＆ （7.1 ±2. 1 ） days （ t = 8.730, P = 0.000）. Compared with general group, the suturing time of common bile duet was significantly shorter in improvement group, the average highest temperature at day 3 post-operation were lower and complications （ bile leakage, bile duet stricture ＆ biliary tract bleeding） decreased significantly. The main hole conversion during common bile duet exploration by laparoseopy offers the advantages of flexibility, convenience and applicability.
出处
《中华全科医师杂志》
2015年第10期784-786,共3页
Chinese Journal of General Practitioners
