不同胆囊切除范围在微创复杂胆囊手术患者中的应用价值比较

目的探讨不同胆囊切除范围在微创复杂胆囊手术中的疗效及其安全性。方法收集复杂胆囊疾病患者100例行腹腔镜手术,随机分为部分胆囊切除术组(A组)和全部胆囊切除术组(B组),每组均50例。观察两组患者的临床疗效和不良事件。结果 A组与B组比较,手术时间无明显差异(P0.05);而术中平均出血量为(46.15±8.41)ml vs.(88.16±9.52)ml,B组患者明显多于A组(P0.05)。A组术中无中转开腹者,术后仅1例患者发生胆瘘;B组术中8例中转开腹,9例术后发生并发症,两组比较均有统计学差异(P0.05)。术后A组患者的术后进食时间、引流管拔出时间、住院时间均早于B组(P0.05)。结论部分胆囊切除术在微创复杂胆囊手术患者中具有出血量少、术中安全性高及术后并发症少等优点。

The Application Value of Difficult Laparoscopic Cholecystectomy

Objective To explore the efficacy and safety of the range of different cholecystectomy in difficult laparoscopic cholecystectomy patients. Methods 100 cases with complicated gallbladder disease were collected. All the patients were randomly divided into partial laparoscopic cholecystectomy group （A group） and total laparoscopic cholecystectomy group （B group）, 50 cases for each. Then the clinical efficacy and adverse events were observed. Results There was no significant difference of the operative time between the two groups （P 〉0.05）. The mean amount bleeding of group A and B was （46.15 ± 8.41 ） ml vs. （88.16 ± 9.52） ml respectively. And B group was significantly higher than A group （P 〈 0.05）. There was no patient converted to open cholecystectomy and one patients occurred complication postoperatively in A group. There was eight pa- tients converted to open cholecystectomy, and nine patients occurred postoperative complications in B group. The difference of the two group＇s conversion rate and postoperative complication rate was statistically significant （P 〈 0.05 ）. The back to normal diet time, the drainage tube implanted time and hospitalization time of A group were shorter than B group. Conclusion Partial cholecystectomy has such advantages as less bleeding, higher intraoperative security, and fewer complication rates in complex minimally invasive gallbladder surgery.