發(fā)布時(shí)間：2018-04-13 13:15

  本文選題：腹腔鏡手術(shù) + 開(kāi)腹手術(shù)　； 參考：《中國(guó)微創(chuàng)外科雜志》2017年04期

【摘要】：目的探討完全腹腔鏡左半肝切除治療左肝膽管結(jié)石的安全性和可行性。方法回顧性分析2014年1月~2015年12月我院57例因左肝膽管結(jié)石行左半肝切除的臨床資料,其中完全腹腔鏡27例,開(kāi)腹30例。對(duì)比2組手術(shù)時(shí)間、術(shù)中出血量、術(shù)中輸血率、術(shù)后肛門排氣時(shí)間、術(shù)后住院時(shí)間、術(shù)后并發(fā)癥和術(shù)后1周結(jié)石殘留率。結(jié)果與開(kāi)腹組比較,腹腔鏡組手術(shù)時(shí)間短[(339.3±52.6)min vs.(371.5±51.5)min,t=-2.333,P=0.023],術(shù)中出血少[(296.3±157.4)ml vs.(435.5±240.8)ml,t=-2.552,P=0.012],術(shù)中輸血率低[14.8%(4/27)vs.40.0%(12/30),χ~2=4.464,P=0.035],術(shù)后肛門排氣早[(3.2±0.9)d vs.(4.5±1.0)d,t=-4.896,P=0.000],術(shù)后住院時(shí)間短[(8.5±2.5)d vs.(11.3±2.2)d,t=-4.468,P=0.000],2組術(shù)后并發(fā)癥[22.2%(6/27)vs.46.7%(14/30),χ~2=3.728,P=0.054]和術(shù)后1周結(jié)石殘留率[14.8%(4/27)vs.23.3%(7/30),χ~2=0.662,P=0.416]差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論完全腹腔鏡左半肝切除治療左肝膽管結(jié)石安全可行,積極的圍手術(shù)期治療和恰當(dāng)?shù)男g(shù)中處理非常重要。
[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墮棿鐭璠(339.3鹵52.6)min vs.(371.5鹵51.5)min,t=-2.333,P=0.023],鏈腑鍑?guó)櫋�灝慬(296.3鹵157.4)ml vs.(435.5鹵240.8)ml,t=-2.552,P=0.012],鏈腑杈撹鐜囦綆[14.8%(4/27)vs.40.0%(12/30),蠂~2=4.464,P=0.035],鏈悗鑲涢棬鎺掓皵鏃(3.2鹵0.9)d vs.(4.5鹵1.0)d,t=-4.896,P=0.000],鏈悗浣忛櫌鏃墮棿鐭璠(8.5鹵2.5)d vs.(11.3鹵2.2)d,t=-4.468,P=0.000],2緇勬湳鍚庡茍鍙戠棁[22.2%(6/27)vs.46.7%(14/30),蠂~2=3.728,P=0.054]鍜屾湳鍚，

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