腹腔镜左半肝切除在肝内胆管结石患者中的治疗效果分析

目的探讨左肝内胆管结石患者接受腹腔镜循肝中静脉入路解剖性左半肝切除术治疗的效果及复发率。方法选取本院2017年6月—2019年6月收治的左肝内胆管结石患者50例作为研究对象。分为对照组(n=20)和观察组(n=30),对照组给予未循肝中静脉,观察组给予循肝中静脉,对比两组的治疗效果和复发率。结果观察组的手术时间高于对照组(P<0.05),术中出血量、中转开腹患者差异无统计学意义(P>0.05)。术后住院时间、下床活动时间、进食时间及术后排气时间两组差异无统计学意义(P>0.05)。术后对照组胆瘘分级≥B级发生率高于观察组(P<0.05),腹腔脓肿、切口感染等差异无统计学意义(P>0.05)。术后随访8个月,对照组结石复发、胆管炎复发率高于观察组(P<0.05)。结论腹腔镜循肝中静脉入路解剖性左半肝切除术可减少左肝内胆管结石患者术后并发症、复发率。

Laparoscopic Left Hemihepatectomy in the Treatment of Patients With Intrahepatic Bile Duct Stones

Objective To investigate the effect and recurrence rate of laparoscopic left hemihepatectomy via middle hepatic vein approach in patients with left intrahepatic bile duct stones.Methods 50 patients with left intrahepatic bile duct stones in our hospital from June 2017 to June 2019 were selected as the research objects.They were divided into the control group(n=20)and the observation group(n=30).The control group was given the middle hepatic vein,and the observation group was given the middle hepatic vein.Results The operation time of the observation group was significantly higher than that of the control group(P<0.05),and there was no significant difference in the amount of intraoperative blood loss and conversion to open surgery(P>0.05).There was no significant difference in postoperative hospital stay,ambulation time,eating time and postoperative exhaust time between the two groups(P>0.05).The incidence of biliary fistula grade≥B in the control group was significantly higher than that in the observation group(P<0.05),and there was no significant difference in abdominal abscess and incision infection(P>0.05).After eight mouths follow-up,the recurrence rate of stones and cholangitis in the control group was significantly higher than that in the observation group(P<0.05).Conclusion Laparoscopic anatomical left hemihepatectomy via middle hepatic vein approach can reduce postoperative complications and recurrence rate of patients with left intrahepatic bile duct stones.