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1.
胆囊切除术是公认的胆囊良性疾病的治愈手段,国内外学术界对于手术适应证和手术时机已有明确共识。近年来,“保胆手术”治疗胆囊良性疾病颇受热议,一些医生将“保护胆囊”的学术观点等同于“保留胆囊”的手术技术,这种误解可能导致病人出现差异性的预后。因此,临床医师应明晰“保护胆囊”理念与“保胆手术”的差别,对胆囊良性疾病的诊疗原则有正确的理解和应用。 相似文献
2.
目的探讨分析对急性结石性胆囊炎患者采用腹腔镜胆囊切除术进行治疗的临床效果,以及对患者的胃肠功能和C反应蛋白所造成的影响。方法本次研究对象乃是我院肝胆外科于2017年4月-2019年4月期间收治的急性结石性胆囊炎患者62例,按照患者就诊的先后顺序对其进行平均分组,比较两组患者的术后肠鸣音恢复时间、肛门排气时间、排便时间、C反应蛋白水平以及并发症发生率。结果腹腔镜手术组患者的术后肠鸣音恢复时间(13.6±3.5)小时、肛门排气时间(16.5±2.7)小时以及排便时间(25.7±3.3)小时,均明显少于开腹式手术组患者(P<0.05);腹腔镜手术组患者的术后并发症发生率(6.45%)明显低于开腹式手术组患者(25.80%)(P<0.05);腹腔镜手术组患者的C反应蛋白水平为(10.4±2.5)mg/L,少于开腹式手术组患者(P<0.05)。结论根据本次研究的结果可以确认,对急性结石性胆囊炎患者采用腹腔镜胆囊切除术进行治疗能够取得更好的效果,可以促使患者的胃肠功能在术后更快的恢复,提高患者的C反应蛋白,从而有效避免患者出现并发症。 相似文献
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4.
目的探讨脾大部切除加断流术治疗小儿门静脉高压症的临床疗效。方法对16例确诊为门静脉高压症的患儿行脾大部切除加断流术。随访患儿恢复情况。结果16例患儿手术顺利,恢复良好,无死亡病例。无再发消化道出血、脾功能亢进表现,无脾切除术后凶险感染出现。结论保留脾脏的脾大部切除加断流术是治疗小儿门静脉高压症一种较好的手术方法。 相似文献
5.
Palat Balachandran M.S. M.Ch. Shaleen Agarwal M.S. M.Ch. Narendra Krishnani M.D. Chandra M. Pandey Ph.D. Ashok Kumar M.S. M.Ch. Sadiq S. Sikora M.S. Rajan Saxena M.S. Vinay K. Kapoor M.S. 《Journal of gastrointestinal surgery》2006,10(6):848-854
The aim of this study was to examine the predictors of long-term survival (>24 months) in patients with gall bladder cancer.
A retrospective review of 117 cases of gall bladder cancer resected between 1989 and 2000. The resections included 80 simple
cholecystectomies and 37 extended procedures. Patients with survival >24 months (n=44) were compared with those having survival
<24 months (n=73) for 17 prognostic factors. Overall median survival was 16 months with a 5-year survival of 27%. T status
(P=.000) and adjuvant chemoradiotherapy (P=.001) were independent predictors of long-term survival. Survival advantage was
seen in T3N+ve disease (P=.007) with extended procedures. Complete (R0) resection was attained in 30 patients with a 5-year
survival advantage of 30% as compared with incomplete (R1) resection (P=.0002). Adjuvant chemoradiotherapy improved survival
in simple cholecystectomy group (P=.0008) but no advantage was seen after extended procedures. Stage III (P=.001) and node-positive
disease (P=.0005) had significant benefit with adjuvant therapy. Poor differentiation and vascular invasion were associated
with poor long-term survival. R0 resection was associated with prolonged survival. Extended procedures improved survival in
patients with T3N+ve disease. Addition of chemoradiotherapy made significant improvement in long-term survival in stage III
and node-positive lesions and in patients undergoing simple cholecystectomy. R0 resection predicted long-term survival in
gall bladder cancer. T3 N+ve disease had better survival after extended procedures. Adjuvant chemoradiotherapy improved survival
in stage III and node-positive disease. Poor differentiation and vascular invasion were adverse predictors of survival. 相似文献
6.
梁华 《国际医药卫生导报》2006,15(1):48-51
目的 探讨腹腔镜胆囊切除术(LC)常见并发症的发生原因及预防措施.方法 回顾性分析本院1998至2007年完成的1126例腹腔镜胆囊切除术患者的临床资料,将患者分为实验组以及对照组,在实验组患者手术过程中采取一系列针对性的措施预防并发症的发生.而对照组采用传统的手术方式及围术期护理.将两组的并发症发生率进行比较.结果 实验组并发症发生率为1.62%,明显低于对照组的3.86%,两组比较,具有统计学意义.结论 腹腔镜胆囊切除术是胆囊切除的最佳选择,但仍存在较严重的并发症,遵循正规的手术原则,及时中转开腹,才能减少并发症,保证手术质量. 相似文献
7.
朱益军 《中华现代外科学杂志》2006,3(8):678-679
目的探讨经胆囊管造影在单纯性胆囊切除术中的价值。方法回顾分析本院在1991年1月-2004年12月间1569例单纯性胆囊切除术中常规经胆囊管造影胆管结石的发生率。结果1023例无胆总管探查指征,经术中胆囊管造影51例,阳性49例,经探查证实有结石,546例有胆总管相对探查指征,经胆囊管造影158例阳性,151例探查证实。结论单纯性胆囊切除术中常规经胆囊管造影可发现隐匿性胆总管结石,能有效减少胆管残余结石,减少胆道损伤。 相似文献
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9.
H. S. Tilney R. E. Lovegrove S. Purkayastha A. G. Heriot A. W. Darzi P. P. Tekkis 《Colorectal disease》2006,8(5):441-450
AIM: The present meta-analysis aims to compare short-term and long-term outcomes in patients undergoing laparoscopic or open subtotal colectomy for benign and malignant disease. METHODS: A literature search of Medline, Ovid, Embase and Cochrane databases was performed to identify studies published between 1992 and 2005, comparing laparoscopic (LSC) and open (OSC) subtotal colectomy. A random effect meta-analytical technique was used and sensitivity analysis performed on studies published since the beginning of 2000, higher quality papers, those reporting on more than 40 patients, and those studies reporting on adult cases or acute colitis. RESULTS: A total of eight studies satisfied the criteria for inclusion. These included outcomes on 336 patients, 143 (42.6%) of whom had undergone laparoscopic resection, with an overall conversion rate to open surgery of 5% (range 0-11.8%). Operative time was significantly longer in the laparoscopic group by 86.2 min (P < 0.001) and throughout subgroup analysis, although it was only in patients with acute colitis that this finding was without significant heterogeneity. Operative blood loss was less in the laparoscopic group by 57.5 millilitres in high quality and studies published since 2000, and 65.3 millilitres in those reporting on more than 40 patients. There was no significant difference in early or long-term complications between the groups. A statistically significant reduction in length of postoperative stay was observed in the laparoscopic groups by 2.9 days (P < 0.001). CONCLUSION: Laparoscopic subtotal colectomy was associated with longer operating times but a reduced length of stay compared to open surgery. Although short-term outcomes were equivalent in both groups, the suggested benefits in terms of reduced long-term obstructive complications were not supported by this meta-analysis. 相似文献
10.