AIM: To investigate celiac artery variations in gastric cancer patients and the impact on gastric cancer surgery,and also to discuss the value of the ultrasonic knife in reducing the risk caused by celiac artery varia...AIM: To investigate celiac artery variations in gastric cancer patients and the impact on gastric cancer surgery,and also to discuss the value of the ultrasonic knife in reducing the risk caused by celiac artery variations.METHODS: A retrospective analysis was conducted to investigate the difference in average operation time,intraoperative blood loss, number of harvested lymph nodes, average postoperative drainage within 3 d,and postoperative hospital stay between the group with vascular variations and no vascular variations,and between the ultrasonic harmonic scalpel and conventional electric scalpel surgery group.RESULTS: One hundred and fifty-eight cases presented with normal celiac artery, and 80 presented with celiac artery variation(33.61%). The average operation time,blood loss, average drainage within 3 d after surgery in the celiac artery variation group were significantly more than in the no celiac artery variation group(215.7 ± 32.7 min vs 204.2 ± 31.3 min, 220.0 ± 56.7mL vs 163.1 ± 52.3 mL, 193.6 ± 41.4 mL vs 175.3± 34.1 mL, respectively, P < 0.05). In celiac artery variation patients, the average operation time, blood loss, average drainage within 3 d after surgery in the ultrasonic harmonic scalpel group were significantly lower than in the conventional electric scalpel surgery group(209.5 ± 34.9 min vs 226.9 ± 29.4 min, 207.5 ±57.1 mL vs 235.6 ± 52.9 mL, 184.4 ± 38.2 mL vs 205.0± 42.9 mL, respectively, P < 0.05), and the number of lymph node dissections was significantly higher than in the conventional surgery group(25.5 ± 9.2 vs 19.9 ±7.8, P < 0.05).CONCLUSION: Celiac artery variation increases thedifficulty and risk of radical gastrectomy. Preoperative imaging evaluation and the application of ultrasonic harmonic scalpel are conducive to radical gastrectomy.展开更多
目的:对比研究超声刀(ultrasonic harmonic scalpel,UHS)与高频电刀(high-frequency mono-polar electronic scalpel,HMES)在腹腔镜胆道探查术(laparoscopic common bile duct exploration,LCBDE)中的应用价值。方法:回顾分析216例LCBD...目的:对比研究超声刀(ultrasonic harmonic scalpel,UHS)与高频电刀(high-frequency mono-polar electronic scalpel,HMES)在腹腔镜胆道探查术(laparoscopic common bile duct exploration,LCBDE)中的应用价值。方法:回顾分析216例LCBDE患者的临床资料,其中98例术中应用UHS(A组),118例术中应用HMES(B组);对比分析两组手术时间、术中出血量、中转开腹率、术后胆漏率、术后出血量及住院时间;检测两组患者术前及术后第1天、第3天、第5天ALT、AST、TBIL、DBIL、GGT、ALP水平。结果:两组患者手术时间、术中出血量、中转开腹率、术后胆漏率、术后出血量及住院时间差异均无统计学意义(P>0.05);肝功能检测显示,与术前比较,A组术后第1天,B组术后第1天、第3天ALT、AST明显升高(P<0.05),第5天两组均恢复至正常水平;术后第3天两组间差异有统计学意义(P<0.05)。两组患者术后第3天、第5天TBIL、DBIL水平较术前及术后第1天显著降低,术后第5天较第3天显著下降(P<0.05);术后第5天两组ALP、GGT较术前显著下降,两组间相比差异无统计学意义(P>0.05)。结论:LCBDE术中应用UHS、HMES均是安全、有效的,可有效解除胆道梗阻。展开更多
文摘AIM: To investigate celiac artery variations in gastric cancer patients and the impact on gastric cancer surgery,and also to discuss the value of the ultrasonic knife in reducing the risk caused by celiac artery variations.METHODS: A retrospective analysis was conducted to investigate the difference in average operation time,intraoperative blood loss, number of harvested lymph nodes, average postoperative drainage within 3 d,and postoperative hospital stay between the group with vascular variations and no vascular variations,and between the ultrasonic harmonic scalpel and conventional electric scalpel surgery group.RESULTS: One hundred and fifty-eight cases presented with normal celiac artery, and 80 presented with celiac artery variation(33.61%). The average operation time,blood loss, average drainage within 3 d after surgery in the celiac artery variation group were significantly more than in the no celiac artery variation group(215.7 ± 32.7 min vs 204.2 ± 31.3 min, 220.0 ± 56.7mL vs 163.1 ± 52.3 mL, 193.6 ± 41.4 mL vs 175.3± 34.1 mL, respectively, P < 0.05). In celiac artery variation patients, the average operation time, blood loss, average drainage within 3 d after surgery in the ultrasonic harmonic scalpel group were significantly lower than in the conventional electric scalpel surgery group(209.5 ± 34.9 min vs 226.9 ± 29.4 min, 207.5 ±57.1 mL vs 235.6 ± 52.9 mL, 184.4 ± 38.2 mL vs 205.0± 42.9 mL, respectively, P < 0.05), and the number of lymph node dissections was significantly higher than in the conventional surgery group(25.5 ± 9.2 vs 19.9 ±7.8, P < 0.05).CONCLUSION: Celiac artery variation increases thedifficulty and risk of radical gastrectomy. Preoperative imaging evaluation and the application of ultrasonic harmonic scalpel are conducive to radical gastrectomy.
文摘目的:对比研究超声刀(ultrasonic harmonic scalpel,UHS)与高频电刀(high-frequency mono-polar electronic scalpel,HMES)在腹腔镜胆道探查术(laparoscopic common bile duct exploration,LCBDE)中的应用价值。方法:回顾分析216例LCBDE患者的临床资料,其中98例术中应用UHS(A组),118例术中应用HMES(B组);对比分析两组手术时间、术中出血量、中转开腹率、术后胆漏率、术后出血量及住院时间;检测两组患者术前及术后第1天、第3天、第5天ALT、AST、TBIL、DBIL、GGT、ALP水平。结果:两组患者手术时间、术中出血量、中转开腹率、术后胆漏率、术后出血量及住院时间差异均无统计学意义(P>0.05);肝功能检测显示,与术前比较,A组术后第1天,B组术后第1天、第3天ALT、AST明显升高(P<0.05),第5天两组均恢复至正常水平;术后第3天两组间差异有统计学意义(P<0.05)。两组患者术后第3天、第5天TBIL、DBIL水平较术前及术后第1天显著降低,术后第5天较第3天显著下降(P<0.05);术后第5天两组ALP、GGT较术前显著下降,两组间相比差异无统计学意义(P>0.05)。结论:LCBDE术中应用UHS、HMES均是安全、有效的,可有效解除胆道梗阻。
