腹腔镜与开腹左肝内胆管结石左半肝切除术疗效对比

目的探讨腹腔镜与开腹左半肝切除术治疗左肝内胆管结石的临床疗效与安全性。 方法回顾性分析2010年1月至2013年12月收治的左肝内胆管结石患者73例，分为腹腔镜组(35例)和开腹组(38例)。采用SPSS17.0软件对数据进行统计学分析，两组患者术中术后等计量资料以( ±s)表示，采用独立t检验；术中输血率、止痛药使用率、术后结石清除率、结石复发率及并发症发生率等计数资料组间比较采用χ²检验，以P<0.05差异有统计学意义。 结果腹腔镜组患者手术时间长于开腹组，术中出血量、术中输血率、止痛药使用率、肛门排气时间、下床活动时间、恢复饮食时间以及平均住院时间均明显短(低)于与开腹组(P<0.05)；两组患者术后结石清除率、结石复发率及并发症发生率比较差异无统计学意义(P>0.05)。 结论腹腔镜左半肝切除术治疗左肝内胆管结石是安全可行的，具有局部创伤小、术后恢复快等优势。

Comparative effect of laparoscopic and laparotomy left hemihepatectomy for left intrahepatic bile duct stone

ObjectiveTo investigate the clinical efficacy and safety of laparoscopic and laparotomy left hemihepatectomy in treating left intrahepatic bile duct stone. MethodsFrom January 2010 to December 2013, 73 patients with left intrahepatic bile duct stone were enrolled in this study, including 35 cases in laparoscopic group and 38 cases in laparotomy group. Statistical analysis were performed by using SPSS17.0 software, the intraoperative and postoperative measurement data were expressed as and examined by Student’s t test. Count data such as intraoperative blood transfusion rate, analgesic use rate, stone clearance rate, recurrence rate and postoperative complication rate were examined by Chi-square test, P value<0.05 was considered as statistically significant difference. ResultsThe operation time in laparoscopic group was significantly longer than that in laparotomy group, intraoperative blood loss, intraoperative blood transfusion rate, analgesic use rate, postoperative anal exhaust time, ground activity time, diet recovery time and average hospitalization time in laparoscopic group were significantly shorter (lower) than those in laparotomy group (P<0.05); No significant differences were found in tone clearance rate, recurrence rate and postoperative complication rate between the two groups (P>0.05). ConclusionLaparoscopic left hemihepatectomy for the treatment of left intrahepatic bile duct stone is feasible and safe, and has the benefits of small trauma, quick postoperative recovery.