快速康复理念在肝胆外科围手术期的体会

【摘要】〓目的〓探讨腹腔镜及胆道镜在肝胆手术快速康复外科的应用。方法〓分析总结2009年11月至2014年5月192例行肝胆手术患者采用快速康复外科理念指导下进行诊治,及腹腔镜及胆道镜在肝胆手术中应用的经验和体会。结果〓死亡病例。192例病人远期随访,行保胆取石114例,有4例复发,1例行胆囊切除术,3例无明显症状,予以定期随访。经“T”管窦道胆道镜探查取石46例,均经1次到最多5次完成取石。其他肝胆手术32例,2例出现但漏,经保守均治愈。结论〓肝胆手术中,只要发挥腹腔镜及胆道镜优势,能够体现快速康复外科的理念。

Experience in fast-track concept applied in perioperative period of hepatobiliary surgery hepatic surgery operation

Objective To investigate the effect of fast-track in hepatic surgery operation.Methods From Nov 2009 to May 2014,192 cases of hepatobiliary operation were treated by laparoscopy and choledochoscopy under the guidunce of fast-track surgery. The surgical experience in hepatobiliary operation was described. Results No case died in prerioperative period in 192 cases, 114 underwent surgical procedure with laparoscopic mini-cholecystolithotomy with gallbladder preserved and choledochoscopic stone extraction in which there were 4 cas es of recurrence（1 case underwent cholecystectomy, 3 cases were followed up regularly）. Forty-six cases with postoperative residual bile duct stones were treated by choledochoscopic stone extraction from T tube in 6 week after operation. The other surgical operation were performed in 32 cases, including LC without T tube, tumor of bile duct,laparoscopic hepatectomy, etc. Conclusion Both laparoscopy and choledochoscopy in hepatobiliary operation embody the concept of rapid rehabilitation surgery.