摘要
目的探究腹腔镜与开腹手术在BismuthⅠ型肝门胆管癌根治术的临床疗效。方法回顾性分析2013年1月至2015年12月诊断为BismuthⅠ肝门胆管癌患者资料27例,根据不同术式分为开腹组14例行开腹根治术,腹腔镜组13例行腹腔镜根治术。采用SPSS20.0软件进行数据分析,围手术期指标、肝功能指标等计量资料采用(X^-±S)表示,独立t检验;术后并发症比较采用χ^2检验;远期生存率分析采用Kaplan-Meier法。P<0.05为差异具有统计学意义。结果两组术中淋巴结清扫个数、术后排气时间及切缘阳性数比较,差异无统计学意义(P>0.05);腹腔镜组手术时间长于开腹组,但术中出血、疼痛时间、住院时间等方面均优于开腹组(P<0.05)。两组患者术前肝功能指标各项指标差异无统计学意义(P>0.05)。术后3 d,两组TBIL、Alb较术前明显降低,腹腔镜组TBIL小于开腹组、Alb大于开腹组(P<0.05);两组ALT、AST较术前明显增加,腹腔镜组小于开腹组(P<0.05);两组患者术后并发症发生率和1、3年累积生存率差异无统计学意义(P>0.05)。结论腹腔镜BismuthⅠ肝门胆管癌根治术相对开腹手术切口小、出血少、肝功能损伤小,安全可行。
Objective To investigate the clinical effect of laparoscopy and laparotomy in radical resection of BismuthⅠhilar cholangiocarcinoma.Methods From January 2013 to December 2015,27 patients with BismuthⅠhilar cholangiocarcinoma underwent laparoscopic or open surgery in our hospital,whose clinical data were analyzed retrospectively,including 14 cases in laparotomy group and 13 cases in laparoscopic group.Data analysis were performed by using SPSS20.0 software.Measurement data such as perioperative indexes were expressed as mean±standard deviation and were examined by independent t test.The incidence of complications were examined by chi square test.Survival was analyzed by kaplan-meier method.A P value of<0.05 was considered as statistically significant.Results There were no significant difference in terms of harvested lymph nodes,postoperative exhaust time and positive cases of surgical margin between the two groups(P>0.05).The operation time in laparoscopic group was longer than that in open group,while intraoperative bleeding,pain and hospitalization time were significantly better than those in laparotomy group,with statistically difference(P<0.05).There was no significant difference in terms of liver function indexes between the two groups before operation(P>0.05).On the 3rd day after operation,TBIL,Alb in both groups was significantly lower than those before operation respectively,TBIL in laparoscopy group was lower than that in laparotomy group,Alb in laparoscopy group was higher than that in laparotomy group,ALT,AST in both groups were significantly higher than those before operation,with lower level in laparoscopy group than those laparotomy group respectively(P<0.05).There was no significant difference in terms of incidence of postoperative complications and 1,3-year cumulative survival rate between the two groups(P>0.05).Conclusion Compared with open surgery,laparoscopic radical resection of BismuthⅠhilar cholangiocarcinoma have advantages of smaller incision,less bleeding and liver function damage,w
作者
段畅
朱求实
王满贞
牛彦锋
张万里
李士军
Duan Chang;Zhu Xushi;Wang Manzhen;Niu Yanfeng;Zhang Wanli;Li Shijun(Department of General surgery,People’s Hospital of Wuhan Huangpi District(the affiliated hospital of Jianghan University),Hu Bei 430300,China;Department of General surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hu Bei 430300,China;Department of General surgery,people’s Hospital of Wuhan University,Hu Bei 430200,China)
出处
《中华普外科手术学杂志（电子版）》
2019年第6期552-555,共4页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
湖北省自然科学基金(项目编号WJ2015MB075)~~
关键词
胆管肿瘤
腹腔镜检查
剖腹术
疗效比较研究
Bile duct neoplasms
Laparoscopy
Laparotomy
Comparative effectiveness research
