腹腔镜胆囊次全切除术的临床应用

目的：探讨腹腔镜胆囊次全切除术的可行性，总结困难型腹腔镜胆囊切除术的经验，尤其是腹腔镜胆囊次全切除理念在困难型腹腔镜胆囊切除术中的体现及应用。方法回顾分析我院2008年1月至2013年10月所行腹腔镜胆囊次全切除病例，并以2011年5月为时间节点分为 A 组（节点前时段）、B 组（节点后时段）,分别比较前后两组的（胆囊切除实行专病专治），手术时间、术后住院时间、术中出血量。结果 B 组手术时间（78.1±6.6）min 少于 A 组（97.5±7.3）min，B 组术后住院时间（3.5±0.4）d 少于 A 组（5.6±0.5）d，出血量 B 组（68.9±7.2）ml 多于 A 组（56.7±7.7）ml。差异均有统计学意义。结论腹腔镜胆囊次全切除应成为腹腔镜术者的常规理念；熟练掌握腹腔镜技术、积累一定经验后，腹腔镜胆囊次全切除可作为常规手术操作应用于临床。

Clinical application of laparoscopic subtotal cholecystectomy

Objective To discuss the fessibility of laparoscopic subtotal cholecystectomy （DLC）, especially the use of the idea about laparoscopic subtotal cholecystectomy（LSC）. Methods A retrospective study covering LSC cases from January 2008 to October 2013 was performed,and May 2011 was time point （cholecystectomy was done by dedicated department）,Operative time （OT）、postoperative hospital stay （PHS） and blood loss（BL） during two periods were compared. Results OT during latter period （78.1± 6.6）min was less than anterior（97.5±7.3）min,PHS（3.5±0.4）d during latter period was less than anterior （5.6±0.5）d,BL during latter period（68.9±7.2）ml was more than anterior（56.7±7.7）ml. The differences were statistical significance.Conclusions LSC should be a routine concept to the laparoscopic surgeons.For surgeons who expertly grasp laparoscopic tecniques,have enough experiences,LSC can be routine procedure during clinical operation.