腹腔镜左半肝切除术治疗肝胆管结石的应用研究

发布时间：2018-01-12 17:08

本文关键词：腹腔镜左半肝切除术治疗肝胆管结石的应用研究　出处：《腹腔镜外科杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的:探讨完全腹腔镜左半肝切除术治疗左肝胆管结石病的临床应用价值。方法:回顾分析2013年6月至2015年9月为33例左肝胆管结石患者行腹腔镜左半肝切除术的临床资料。在腹腔镜下行左半肝切除、胆道检查并放置T管。术后6周行超声、CT、胆道镜检查或T管造影了解有无结石残留等并发症。患者均得到随访。结果:31例患者顺利完成腹腔镜手术,2例中转开腹,术中生命体征平稳,手术时间平均(177±56)min,术中出血量平均(317±57)ml,术后胃肠功能恢复时间24~48 h,平均(29.0±15.3)h,术后48~72 h拔除腹腔引流管。术后1例发生胆漏,经引流后痊愈;1例出现切口感染,经加强换药、调整血糖后痊愈,1例患者出现膈下积液,行穿刺引流治愈。平均住院(8.7±1.7)d。术后随访1~24个月,均恢复良好,无胆道狭窄、结石复发等并发症发生。结论:由经验丰富的腹腔镜医师开展腹腔镜左半肝切除术治疗左肝胆管结石是安全、可行的,值得临床推广应用。
[Abstract]:Objective: To investigate the effect of laparoscopic left hepatectomy clinical value in patients with left hepatolithiasis. Methods: a retrospective analysis from June 2013 to September 2015 for the clinical data of 33 patients with hepatolithiasis underwent laparoscopic left hepatectomy. Resection in laparoscopic left liver, biliary tract examination and placement of T tube after operation. The 6 week ultrasound, CT, choledochoscopy or T tube cholangiography know no residual stones. The patients were followed up. Results: 31 patients were successfully completed laparoscopic surgery, 2 cases were converted to laparotomy, vital signs were stable during the operation, the operation time was (177 + 56) min, the average amount of bleeding during the operation (317 + 57) ml, postoperative gastrointestinal function recovery time of 24~48 h, the average (29 + 15.3) h, 48~72 h removal of abdominal drainage tube after operation. 1 cases of bile leakage were cured after drainage; incision infection occurred in 1 cases, by strengthening the dressing, adjusting blood glucose recovered in 1 cases patient The subphrenic effusion, puncture and drainage. The average hospitalization (8.7 + 1.7) d. patients were followed up 1~24 months, all recovered well, no biliary stricture occurred, stone recurrence and other complications. Conclusion: the laparoscopic physician experienced laparoscopic left liver resection in treatment of hepatolithiasis is safe and feasible. And it is worthy of clinical application.

【作者单位】：遂宁市中心医院;四川大学华西医院;
【分类号】：R657.4
【正文快照】： 肝胆管结石发病率高,其中左肝内胆管结石患者临床较多见,常引起患者腹痛、发热、黄疸,甚至部分出现恶变等,往往需要手术切除,以往常选择开腹左半肝切除术,随着腹腔镜技术的发展及手术经验的积累,越来越多的患者选择施行腹腔镜左半肝切除术。现回顾分析2013年6月至2015年9月我

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