3D腹腔镜在复杂性胆囊切除术中的临床应用

目的探讨3D腹腔镜在复杂性胆囊切除术中的临床应用价值。方法收集我院2014年3月~2015年3月间复杂性胆囊结
石资料，按照所使用的腹腔镜分为2D组和3D组，比较2组患者手术时间、术中出血量、术后并发症、中转开腹机率、术后排气时
间及术后住院天数。结果共计纳入89例，其中3D组46例，2D组43例；3D组43例成功完成LC，中转开腹3例，2D组39例成功
完成LC，中转开腹4例；3D组和2D组手术时间分别为50.5±15.2 mL和65.4±18.1 min，两组比较差异有统计学意义（P<0.05）；
3D组和常规组术中失血量分别为34.1±13.6 mL和44.5±22.3 mL；两组比较差异有统计学意义（P<0.05）；两组在中转开腹率、术
后排气时间、术后住院天数差异无统计学意义（P>0.05）。结论3D腹腔镜能提供清晰的三维立体视觉，良好的深度感，可实现
精确操作，在复杂性胆囊切除术中有助于缩短手术时间，减少术中出血量，值得在临床手术中推广。

Application of three-dimensional laparoscopic cholecystectomy for complicated gallstone disease

Objective To investigate the clinical value of three-dimensional (3D) laparoscopic cholecystectomy in the treatment
of complicated gallstone disease. Methods From March 2014 to March 2015, 46 patients underwent cholecystectomy for
complicated gallstone disease under 3D laparoscopy (3D group) and 43 received 2D laparoscopic cholecystectomy (2D group).
The surgical data including the operative time, intraoperative blood loss, the rate of conversion to open laparotomy, recovery
time of postoperative bowel motion and hospital stay were compared between the 2 groups. Results Laparoscopic
cholecystectomy was successfully completed in 43 patients in 3D group and in 39 patients in 2D group, and the rates of
conversion to open laparotomy were similar between the two groups (P>0.05). The median operation time was significantly
shorter in 3D group than in 2D group (50.5±15.2 vs 65.4±18.1 min, P<0.05), and the median volume of intraoperative blood loss
was significantly smaller in 3D group (34.1±13.6 vs 44.5±22.3 mL, P<0.05). No significant differences were found in the recovery
time of postoperative bowel motion and postoperative hospital stays between the two groups (P>0.05). Conclusion 3D
laparoscopy, which provides three-dimensional vision with a good sense of depth to allow precise surgical manipulation, can
shorten the operation time and reduce the rate of conversion to open laparotomy for patients undergoing 3D laparoscopic
cholecystectomy for complicated gallstone disease.