复杂胆囊结石患者行腹腔镜胆囊次全切除术的临床疗效观察

目的 观察复杂胆囊结石患者行腹腔镜胆囊次全切除术的临床疗效.方法 按入院先后顺序将186例复杂性胆囊结石患者随机分为观察组与对照组,每组93例.观察组给予腹腔镜下胆囊次全切除术,对照组给予腹腔镜下逆行胆囊切除术.统计并比较两组患者的手术时间、术中出血量、中转开腹率、腹腔引流量、住院时间及术后并发症发生情况等各项临床指标.结果 观察组的手术时间（83.6±17.8）min]短于对照组（115.2±19.7）min],术中出血量（91.4±21.5）ml]也少于对照组（112.0±38.6）ml],组间比较,差异具有统计学意义（均P＜0.05）;观察组的中转开腹率（3.2％）、腹腔引流量（116.5±32.1）ml]、住院时间（6.1±1.1）d]、并发症发生率（7.5％）,与对照组的中转开腹率（2.1％）、腹腔引流量（110.3±30.5）ml]、住院时间（6.7±1.2）d]、并发症发生率（8.6％）相似,组间比较,差异无统计学意义（P＞0.05）.结论 腹腔镜下次全胆囊切除术治疗复杂胆囊结石的手术效果与腹腔镜下逆行胆囊切除术相仿,但手术时间更短,术中出血量更少,疗效显著,值得临床推广应用.

Clinical observation of patients with complex gallstone underwent laparoscopic subtotal hysterectomy

Objective To explore the clinical efficacy of patients with complex gallstone underwent laparoscopic subtotal hysterectomy.Methods According to the order of admission,186 patients with complex gallstone patients were randomly divided into observation group and control group（n=93）.Observation group received laparoscopic gallbladder gallbladder subtotal resection,the control group received laparoscopic retrograde cholecystectomy.Statistics and two groups were compared operative time,blood loss,laparotomy rate,abdominal drainage,hospital stay and postoperative complications,etc.of various clinical indicators.Results The operative time （83.6± 17.8） min shorter than the con trolgroup （115.2±19.7） min,blood loss （91.4±21.5） ml is also less than the control group （112.0±38.6） ml,the difference was statistically significant between groups（p〈0.05） ;laparotomy observation group was 3.2% abdominal drainage was （116.5±32.1） ml,hospitalization time was （6.1-±-1.1） d,the complication rate was 7.5%,while the control group laparotomy rate of 2.1 %,abdominal drainage was （110.3±30.5） ml,hospitalization time was （6.7 ± 1.2） d,the complication rate was 8.6%,the difference was not statistically significant between groups（P〉0.05）.Conclusion Laparoscopic cholecystectomy next whole complex gallstone surgery and laparoscopic cholecystectomy retrograde similar,but shorter operative time,less blood loss,a significant effect,worthy of clinical application.