摘要
目的研究脾动脉结扎在肝门胆管癌(HCCA)患者行大范围肝切除中的安全性及减少术后严重并发症的价值。方法选取蚌埠医学院第一附属医院2021年7月至2023年6月行大范围肝切除的22例HCCA患者为对照组,行大范围肝切除联合脾动脉结扎的12例患者为试验组,统计分析两组术前及术后白细胞计数、血小板计数、转氨酶、总胆红素、白蛋白、国际标准化比值等临床资料,以及术后相关并发症资料。结果试验组术前白细胞计数及血小板计数与出院时相比差异无统计学意义,脾动脉结扎后并不会影响脾脏功能,在术后第5天总胆红素水平、国际标准化比值、腹腔引流量以及术后Clavien-DindoⅢ~Ⅴ级并发症发生率、术后住院天数、总费用上均优于对照组(P<0.05)。结论HCCA患者行大范围肝切除时联合脾动脉结扎安全有效,对于减少术后严重并发症、缩短患者术后恢复周期有重要意义。
Objective To investigate the clinical effect of splenic artery ligation in patients with hilar cholangiocarcinoma(HCCA)undergoing major liver resection(MLR).Methods Twenty-two patients admitted to the First Affiliated Hospital of Bengbu Medical College from July 2021 to June 2023 with HCCA undergoing MLR alone were selected as the control group,and twelve patients undergoing MLR combined with splenic artery ligation(SAL)were selected as the trial group.The preoperative and postoperative clinical data of white blood cell count,platelet count,transaminases,total bilirubin(TB),albumin(ALB),international normalized ratio(INR),and postoperative complications in both groups were analyzed.Results The preoperative counts of white blood cell and platelet in the trial group were not statistically significant compared with those at discharge,indicating that splenic artery ligation did not affect spleen function.The trial group had better INR,TB,drainage flow,Clavien-Dindo grade-postoperative complications,postoperative hospital days,and total costs than those of the control group on the 5th postoperative day(P<0.05).Conclusion Combining SAL with MLR in patients with HCCA is safe and effective,and it is important to reduce serious postoperative complications and shorten the postoperative recovery period.
作者
徐楠
杨云川
周迟
马翔
鲁正
崔培元
Xu Nan;Yang Yunchuan;Zhou Chi;Ma Xiang;Lu Zheng;Cui Peiyuan(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233000,China)
出处
《中华普通外科学文献（电子版）》
CAS
2024年第4期271-274,共4页
Chinese Archives of General Surgery(Electronic Edition)
关键词
脾动脉结扎
胆管肿瘤
肝门胆管癌
大范围肝切除
Splenic artery ligation
Bile duct neoplasms
Hilar cholangiocarcinoma
Major liver resection
