腹腔镜下逆行全胆囊切除术与次全胆囊切除术治疗复杂胆管病变的效果比较

冉江林; 张绍茂; 文强

doi:10.3969/j.issn.1001-5256.2016.04.030

腹腔镜下逆行全胆囊切除术与次全胆囊切除术治疗复杂胆管病变的效果比较

DOI: 10.3969/j.issn.1001-5256.2016.04.030

1. 广元市精神卫生中心普外科
2. 广旺矿区代池医院外科

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中图分类号: R657.4
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出版历程
- 出版日期: 2016-04-20

Effects of laparoscopic retrograde cholecystectomy versus partial cholecystectomy in treatment of complex bile duct diseases: a comparative analysis

Department of General Surgery, Guangyuan Mental Health Center

摘要

摘要:
目的对比分析腹腔镜下逆行全胆囊切除术与腹腔下逆行次全胆囊切除术治疗复杂胆管病变的临床效果。方法收集2013年6月-2015年3月广元市精神卫生中心诊治的83例胆管病变患者临床资料,其中40例行腹腔镜下逆行全胆囊切除术（A组）,43例行腹腔镜下逆行次全胆囊切除术（B组）,比较两组患者的手术过程及术后恢复情况。计量资料组间比较采用独立样本t检验,治疗前后组内比较采用配对t检验;计数资料组间比较采用χ2检验。结果 B组患者手术时间、术中出血量、术中补液量、腹腔引流量均低于A组,差异均有统计学意义（t值分别为9.245、2.394、2.529、3.603,P值均<0.05）。两组患者中转开腹率、胃肠道功能恢复时间、住院时间差异均无统计学意义（p值均>0.05）。A组与B组患者术后13 d的体温、C反应蛋白测定值组间比较,差异均无统计学意义（P值均>0.05）;两组患者第2、3天体温、C反应蛋白测定值较术后第1天均降低（t值分别为3.184、3.402、3.151、3.390、3.497、5.184、3.916、...
- 胆道疾病 /
- 胆囊切除术,腹腔镜 /
- 治疗
Abstract:
Objective To compare the clinical effect between laparoscopic retrograde cholecystectomy and partial cholecystectomy in the treatment of patients with complex bile duct diseases. Methods The clinical data of 83 patients with bile duct diseases who were diagnosed and treated in Guangyuan Mental Health Center from June 2013 to March 2015 were collected. Among these patients,40 underwent laparoscopic retrograde cholecystectomy( group A),and 43 underwent partial cholecystectomy( group B). The surgical procedure and postoperative recovery were compared between the two groups. The independent samples t- test was applied for comparison of continuous data between groups,and the paired t- test was applied for comparison of continuous data within each group before and after treatment; the chi- square test was applied for comparison of categorical data between groups. Results Compared with group A,group B had a significantly shorter time of operation,a significantly less blood loss,a significantly lower volume of intraoperative fluid infusion,and a significantly lower volume of peritoneal drainage( t = 9. 245,2. 394,2. 529,and 3. 603,all P < 0. 05). The rate of conversion to laparotomy,time to functional recovery of the gastrointestinal tract,and length of hospital stay showed no significant differences between the two groups( all P > 0. 05). The body temperature and C- reactive protein on days 1- 3 after surgery showed no significant differences between the two groups( all P >0. 05),while in both groups,the body temperature and C- reactive protein were significantly lower on the 2nd and 3rd days than on the 1st day.( t = 3. 184,3. 402,3. 151,3. 390,3. 497,5. 184,3. 916,and 6. 024,all P < 0. 05). Group B had a significantly lower incidence of postoperative complications than group A( 2. 33% vs 20. 00%,χ~2= 6. 696,P = 0. 010). Conclusion Compared with laparoscopic retrograde cholecystectomy,partial cholecystectomy can shorten the time of operation and reduce intraoperative bleeding and postoperative complications,and holds promise for clinical application.
- biliary tract diseases /
- cholecystectomy,laparoscopic /
- therapy

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参考文献(13)

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