【摘要】：目的探討腹腔鏡下膽總管切開取石一期縫合術(shù)的學(xué)習(xí)曲線。方法選擇同一手術(shù)組完成的腹腔鏡下膽總管切開取石一期縫合術(shù)患者141例,按手術(shù)時(shí)間早晚依次分為A、B、C、D、E組,前四組每組20例,E組61例。對比各組手術(shù)時(shí)間、術(shù)中出血量、術(shù)后進(jìn)食時(shí)間、術(shù)后膽瘺、住院時(shí)間,判斷學(xué)習(xí)曲線(以例數(shù)表示)。結(jié)果五組均手術(shù)順利。A組與B、C、D、E組手術(shù)時(shí)間、術(shù)中出血量、術(shù)后進(jìn)食時(shí)間、術(shù)后住院時(shí)間比較,P均0.05;B組與C、D、E組比較,P均0.05;C、D、E組兩兩比較,P均0.05。各組中轉(zhuǎn)開腹例數(shù)、術(shù)后膽瘺例數(shù)、術(shù)中鄰近臟器損傷例數(shù)比較,P均0.05。結(jié)論腹腔鏡下膽總管切開取石一期縫合術(shù)學(xué)習(xí)曲線約為40例即可達(dá)到熟練程度。
[Abstract]:Objective to explore the learning curve of laparoscopic choledochotomy for primary suture of choledocholithotomy. Methods 141 cases of laparoscopic choledocholithotomy with primary suture were divided into A, B, C, D, E group, 20 cases in the first four groups and 61 cases in the E group according to the time and time of the operation. The patients were divided into two groups: group A, group B, group C, group D, group E (n = 20). The operative time, intraoperative bleeding, postoperative feeding time, postoperative biliary fistula, hospitalization time and learning curve were compared in each group (expressed by the number of cases). Results the operation was successful in group A and group B, C, D, E, the time of operation, the amount of bleeding during operation, the time of eating after operation and the length of hospitalization after operation in group A were all compared with those in group B, C, D, E, P all were 0.05 in group A and B, C, D, E (P < 0.05). C, D, E group in pairwise comparison, P 0.05. In each group, the number of cases of conversion to abdomen, the number of postoperative biliary fistula and the number of cases of injury of adjacent organs during operation were compared (P 0.05). Conclusion the learning curve of laparoscopic choledocholithotomy is about 40 cases.
【作者單位】： 南昌大學(xué)第二附屬醫(yī)院;峽江縣人民醫(yī)院;南昌大學(xué)第三附屬醫(yī)院;
【基金】：江西省衛(wèi)生廳科技計(jì)劃項(xiàng)目(20131077)
【分類號】：R657.42

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