摘要
目的介绍对完全腹腔镜联合胆道镜保胆取石术的手术技巧的改进,并探讨其临床效果。方法回顾性分析我院2016年6月~2018年3月行改良法保胆取石术的112例患者的临床资料,并与2014年1月~2016年8月行常规保胆取石术的20例患者和2018年1月~2018年3月在日间手术病房行LC手术的112例患者的临床资料进行比较。结果手术时间比较:技术改良组和LC组短于保胆取石组(P<0.05),而技术改良组与LC组比较无明显差异(P>0.05)。术中出血量比较:技术改良组明显少于保胆取石组和LC组(P<0.05),而保胆取石组和LC组比较无明显差异(P>0.05)。术后住院时间比较:技术改良组和LC组短于保胆取石组(P<0.05),而技术改良组和LC组两组间比较无明显差异(P>0.05)。复发率比较:技术改良组(1.8%)低于保胆取石组的10%(P<0.05)。结论全腹腔镜联合胆道镜保胆取石术具有手术时间短、术后住院时间短的优点;其手术时间与LC手术近似。保胆取石手术进行技术改进后可以提高患者和外科医师对该手术的接受度,有利于临床推广;但其远期的复发率尚在观察中,因此严格掌握适应证是其合理应用的关键。
Objective To introduce the improvement of operation skill of cholelithotripsy by total laparoscope combined with choledochoscope,and to discuss its clinical effect.Methods A retrospective analysis was performed for 244 patients who admitted in Suining Central Hospital.Among them,there were 112 underwent modified cholecystolithotomy with gallbladder preservation(the modified group)from June 2016 to March 2018,which were compared to 20 cases who underwent routine cholecystolithotomy with gallbladder preservation(the routine group)from January 2014 to August 2016 and to 112 cases who underwent laparoscopic cholecystectomy(LC group)from January 2018 to March 2018.Results Operation time of the modified group and LC group was shorter than that of the routine group(P<0.05),but there was no significant difference between the modified group and LC group(P>0.05).The intraoperative bleeding volume of the modified group was significantly less than the routine group and LC group(P<0.05),while there was no significant difference between the routine group and LC group(P>0.05).Postoperative hospitalization time of the modified group and LC group were shorter than the routine group(P<0.05),but there was no significant difference between the other two groups(P>0.05).The recurrence rate of the modified group(1.8%)was lower than that of the routine group(10%)(P<0.05).Conclusion The modified total cholelithotripsy using laparoscopy combined with choledochoscope has the advantages of shorter operation time and shorter hospital stay,and its operation time is similar to that of LC.The technical improvement of gallstone-preserving surgery can improve the acceptance of patients and surgeons,which is conducive to clinical promotion.However,the long-term recurrence rate is still under observation,so strict control of indications is the key to its rational application.
作者
戴毅
吴涯昆
刘袁君
赵剑
孟敏
王春华
DAI Yi;WU Ya-kun;LIU Yuan-jun;ZHAO Jian;MENG Min;WANG Chunhua(Department of Hepatobiliary Surgery,Suining Central Hospital,Suining 629000,Sichuan,China;Department of Oncology,Suining Central Hospital,Suining 629000,Sichuan,China)
出处
《中国现代手术学杂志》
2019年第4期250-254,共5页
Chinese Journal of Modern Operative Surgery
关键词
保胆取石术
腹腔镜检查
胆道镜
胆囊结石
技术改进
cholecystolithotomy
laparoscopy
choledochoscope
cholecystolithiasis
technological improvement
