摘要
目的回顾性分析58例腹腔镜肝左外叶切除术临床资料,并与开腹肝左外叶切除术对比,探讨腹腔镜肝左外叶切除术的可行性、优缺点和安全性。方法回顾性分析自贡市第四人民医院肝胆外科收治的行肝左外叶切除术患者166例,根据手术方式不同分为腹腔镜组(n=58)和开腹组(n=108)。对比观察两组一般情况、术中和术后相关指标、手术前后肝功能变化、术后并发症。结果两组手术均一次性成功,无术中死亡病例,均未出现术后再出血。腹腔镜组无中转开腹病例,切口长度、术后住院时间和胃肠道功能恢复时间短于开腹组,术中出血量少于开腹组,差异均有统计学意义(P<0.05);两组手术时间比较差异无统计学意义(P>0.05)。腹腔镜组ALT、AST水平低于开腹组,差异有统计学意义(F_(分组)=68.209、62.343,P<0.05);两组ALT、AST水平表现出先升高后降低的趋势,术前、术后第1天和第3天比较差异有统计学意义(F_(时间)=228.300、179.556,P<0.05);腹腔镜组ALT、AST升高幅度小于开腹组(F_(交互)=103.465、88.302,P<0.05)。两组术后并发症发生率比较差异无统计学意义(χ~2=0.254,P>0.05)。结论腹腔镜肝左外叶切除术是一种安全可行的手术方式,具有创伤小、术后恢复快等优势,建议有条件的医院推广使用。
Objective To retrospectively analyze the clinical data who underwent laparoscope left hepaticlobe resection,and to compare with laparotomy left hepatic lobe resection,for further exploring the advantages,disadvantages,and security of laparoscope left hepatic lobe resection.Methods A total of166patients with lefthepatic lobe resection were retrospectively studied.Patients were divided into laparotomy group(n=108)andlaparoscopic group(n=58).The intraoperative and postoperative related indexes,preoperative and postoperativeliver function changes,postoperative complications were observed.Results The operation were one-time successfulin two groups,there was no intraoperative death case,no transfer laparotomy case,and no postoperativere-bleeding.The incision length,duration of hospital stay and postoperative gastrointestinal function recovery inlaparoscopic group were shorter than those in laparotomy group,intraoperative blood loss was less than laparotomygroup,the difference had statistical significance(P<0.05).The operation duration was similar between thetwo groups(P>0.05).The levels of ALT,AST in laparoscopic group were lower than those in laparotomy group,the difference were statistically significant(Fgroup=68.209,62.343,P<0.05),the levels of ALT,AST in two groupsshowed a trend of first rise then reduction,the difference among preoperative and postoperative1d,3d werestatistically significant(Ftime=228.300,179.556,P<0.05),the levels of ALT,AST in laparoscopic group raisedsmoother than those in laparotomy group(Finteraction=103.465,88.302,P<0.05).The postoperative complicationshad no statistically significant difference between two groups(χ2=0.254,P>0.05).Conclusion Laparoscopic lefthepatic lobe resection is a safe and feasible operation,with small surgical trauma and fast recovery,which can berecommended to apply in conditional hospital.
作者
王学文
杨昆
邱桂刚
杨森
邓腾刚
赖钊
WANG Xue-wen;YANG Kun;QIU Gui-gang;YANG Sen;DENG Teng-gang;LAI Zhao(Department of Hepatobiliary Surgery,Zigong Forth People’s Hospital, Zigong, Sichuan 643000, China)
出处
《肝胆胰外科杂志》
CAS
2017年第4期281-284,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
腹腔镜
肝左外叶切除术
开腹
可行性
laparoscope
left hepatic lobe resection
laparotomy
feasibility
