完全腹腔镜与开腹左半肝切除治疗左肝胆管结石的比较

发布时间：2018-04-13 13:15

  本文选题：腹腔镜手术 + 开腹手术　； 参考：《中国微创外科杂志》2017年04期

【摘要】：目的探讨完全腹腔镜左半肝切除治疗左肝胆管结石的安全性和可行性。方法回顾性分析2014年1月~2015年12月我院57例因左肝胆管结石行左半肝切除的临床资料,其中完全腹腔镜27例,开腹30例。对比2组手术时间、术中出血量、术中输血率、术后肛门排气时间、术后住院时间、术后并发症和术后1周结石残留率。结果与开腹组比较,腹腔镜组手术时间短[(339.3±52.6)min vs.(371.5±51.5)min,t=-2.333,P=0.023],术中出血少[(296.3±157.4)ml vs.(435.5±240.8)ml,t=-2.552,P=0.012],术中输血率低[14.8%(4/27)vs.40.0%(12/30),χ~2=4.464,P=0.035],术后肛门排气早[(3.2±0.9)d vs.(4.5±1.0)d,t=-4.896,P=0.000],术后住院时间短[(8.5±2.5)d vs.(11.3±2.2)d,t=-4.468,P=0.000],2组术后并发症[22.2%(6/27)vs.46.7%(14/30),χ~2=3.728,P=0.054]和术后1周结石残留率[14.8%(4/27)vs.23.3%(7/30),χ~2=0.662,P=0.416]差异无统计学意义。结论完全腹腔镜左半肝切除治疗左肝胆管结石安全可行,积极的围手术期治疗和恰当的术中处理非常重要。
[Abstract]:Objective to evaluate the safety and feasibility of laparoscopic left hemihepatectomy for left hepatolithiasis.Methods from January 2014 to December 2015, the clinical data of 57 patients with left hepatolithiasis underwent left hemihepatectomy in our hospital were retrospectively analyzed, including 27 cases with complete laparoscopy and 30 cases with laparotomy.The time of operation, the amount of blood lost during operation, the rate of blood transfusion during operation, the time of anal exhaust after operation, the postoperative hospitalization time, the postoperative complications and the residual rate of stone 1 week after operation were compared between the two groups.Results compared with the open group,鑵硅厰闀滅粍鎵嬫湳鏃堕棿鐭璠(339.3卤52.6)min vs.(371.5卤51.5)min,t=-2.333,P=0.023],鏈�涓�鍑鸿��灏慬(296.3卤157.4)ml vs.(435.5卤240.8)ml,t=-2.552,P=0.012],鏈�涓�杈撹��鐜囦綆[14.8%(4/27)vs.40.0%(12/30),蠂~2=4.464,P=0.035],鏈�鍚庤倹闂ㄦ帓姘旀棭[(3.2卤0.9)d vs.(4.5卤1.0)d,t=-4.896,P=0.000],鏈�鍚庝綇闄㈡椂闂寸煭[(8.5卤2.5)d vs.(11.3卤2.2)d,t=-4.468,P=0.000],2缁勬湳鍚庡苟鍙戠棁[22.2%(6/27)vs.46.7%(14/30),蠂~2=3.728,P=0.054]鍜屾湳鍚，

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