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中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 152 -154. doi: 10.3877/cma.j.issn.1674-3946.2018.02.019

所属专题: 文献

论著

腹腔镜胆囊动脉入路与传统入路胆囊切除术的对比分析
彭一峰1,(), 莫晔2, 陈国斌1, 叶必鹏1, 刘海林1   
  1. 1. 518000 深圳市南山区西丽人民医院肝胆胃肠科
    2. 518000 深圳市南山区西丽人民医院神经内科
  • 收稿日期:2017-06-20 出版日期:2018-02-26
  • 通信作者: 彭一峰

Comparative analysis of the effect of laparoscopic cholecystectomy: cystic artery approach and conventional approach

Yifeng Peng1,(), Ye Mo2, Guobin Chen1, Bipeng Ye1, Hailin Liu1   

  1. 1. Department of Hepatobiliary and Gastroenterological Surgery, Xili people's Hospital in Nanshan district of Shenzhen
    2. Department of neurology, Xili people's Hospital in Nanshan district of Shenzhen
  • Received:2017-06-20 Published:2018-02-26
  • Corresponding author: Yifeng Peng
  • About author:
    Corresponding author: Peng Yifeng, Email:
引用本文:

彭一峰, 莫晔, 陈国斌, 叶必鹏, 刘海林. 腹腔镜胆囊动脉入路与传统入路胆囊切除术的对比分析[J]. 中华普外科手术学杂志(电子版), 2018, 12(02): 152-154.

Yifeng Peng, Ye Mo, Guobin Chen, Bipeng Ye, Hailin Liu. Comparative analysis of the effect of laparoscopic cholecystectomy: cystic artery approach and conventional approach[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(02): 152-154.

目的

探讨分析腹腔镜胆囊动脉入路与传统入路胆囊切除术的临床资料。

方法

选取2015年3月至2017年5月行腹腔镜胆囊切除术的临床病例240例,根据不同的手术入路方式分为动脉入路组与传统组,动脉入路组患者行腹腔镜下胆囊动脉入路胆囊切除术,传统组患者行腹腔镜下传统入路胆囊切除术,每组各120例。采用SPSS 18.0统计软件对数据进行分析,两组的手术时间、术中出血量、住院时间计量资料以(±s)表示,采用独立t检验,术后并发症的发生率采用χ2检验,以P<0.05为差异有统计学意义。

结果

动脉入路组手术时间和住院时间分别为(43.8±11.1) min和(6.3±2.1) d,与传统组比较,差异无统计学意义(P>0.05);动脉入路组的术中出血量为(5.2±3.3) ml,明显少于传统组(17.4±7.4) ml,差异有统计学意义(P=0.000);动脉入路组与传统组患者术后并发症发生率分别为2.5%和5.8%,两组差异无统计学意义(P>0.05),但动脉入路组未出现胆管损伤病例。

结论

腹腔镜下胆囊动脉入路胆囊切除术可精确胆囊三角解剖,避免胆管损伤,降低术后并发症的发生。

Objective

To analyze the clinical effect of laparoscopic cholecystectomy by cystic artery approach or conventional approach.

Methods

The clinical data of 240 patients undergoing LC from March 2015 to May 2017 were analyzed. Of the patients, 120 cases were received cystic artery approach treatment (ALC group) and 120 cases were received traditional approach treatment (TLC group). Statistical analysis were performed by using SPSS 18.0 software. Measurement data such as duration of operation, perioperative amount of bleeding and the length of stay in hospital were expressed as mean±standard deviation, and were examined by using t test. Count data, such as postoperative complication rate were examined by using χ2 test, A P value<0.05 was considered as statistically significant difference.

Results

There were no significant diffenrence in the duration of operation and the length of stay in hospital between the two groups (P>0.05). the perioperative amount of bleeding were significantly lower in the ALC group (5.2±3.3) ml than in the TLC group (17.4±7.4) ml (P=0.000). The incidence rate of postoperative complications were 2.5% and 5.8% in the ALC group and TLC group respectively, there were no difference between the two groups (P>0.05), butnobile duct injury cases were found in ALC group.

Conclusion

The technique of Cystic artery approach used in LC can meticulously dissect the Calot's triangle, prevent bile duct injury effectively, and reduce the incidence rate of postoperative complication.

表1 240例行腹腔镜胆囊切除术患者不同手术入路方式两组术中术后指标比较(±s)
[1]
Wysocki AP. Population-based studies should not be used to justify a policy of routine cholangiography to prevent major bile duct injury during laparoscopic cholecystectomy[J]. World J Surg,2017, 41(1):82-89.
[2]
Mishra PK, Saluja SS, Nayeem M, et al. Bile duct injury-from injury to repair: an analysis of management and outcome[J]. Indian J Surg,2015, 77(Suppl 2):536-542.
[3]
王树金,李宁,李蓓,等. LC联合LCBDE对老年与非老年胆囊结石合并胆总管结石患者的临床疗效对比分析[J].中国普外基础与临床杂志,2016,23(12):1455-1459.
[4]
张建涛,吴畏,钱惠岗,等.不同手术方案在复杂胆总管结石患者中的效果研究[J].中国内镜杂志,2016,22(2):11-14.
[5]
Ejaz A, Spolverato G, Kim Y, et al. Long-term health-related quality of life after iatrogenic bile duct injury repair[J]. J Am Coll Surg, 2014, 219(5):923-932.e10.
[6]
Dominguez-Rosado I, Sanford DE, Liu J, et al. Timing of surgical repair after bile duct injury impacts postoperative complications but not anastomoticpatency[J]. Ann Surg, 2016, 264(3):544-553.
[7]
张武,辛本磊,许传斌,等. 256层螺旋CT观测胆囊动脉起源和直径[J].中国临床解剖学杂志,2016,34(4):388-391.
[8]
Li T, Kim G, Chang S. Tips and tricks to avoid bile duct injury in SILC: an experience of 500 cases[J]. Surg Endosc, 2016, 30(11):4750-4755.
[9]
Boni L, Fingerhut A. Toward 0% bile duct injury during laparoscopic cholecystectomy?[J]. Surg Innov, 2016, 23(2):113-114.
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