手助腹腔镜联合胆道镜行肝左外叶切除胆总管探查术

目的探讨手助腹腔镜联合胆道镜行肝左外叶切除胆总管探查的可行性及优越性。方法对2005年9月—2005年12月收治的左肝内胆管及胆总管结石患者,分别施行手助腹腔镜肝左外叶切除联合胆道镜胆总管探查手术(10例)及开腹肝左外叶切除加胆总管切开探查T管引流术(12例),并对两组患者术后住院时间、手术并发症及术后肝功能恢复状况进行比较研究。结果腹腔镜联合胆道镜手术组与开腹手术组比较,两组手术时间无显著性差异,但手助腹腔镜组住院时间明显缩短、住院费用明显降低,手术并发症明显减少,术后肝功能恢复状况两组比较无显著性差异。结论手助腹腔镜肝左外叶切除联合胆道镜胆总管探查手术在不延长手术时间、加重肝功破坏的情况下,可明显缩短患者住院时间、减少住院费用及术后并发症的发生,具有更高的优越性。

Laparoscopic left lateral hepatectomy combined with choledochoscopic exploration of common bile duct

Objective To investigate the possibilities and advantages of laparoscopic left lateral hepatectomy combined with choledochoscopic exploration of common bile duct.Methods Laparoscopic left lateral hepatectomy combined with choledochoscopic exploration of common bile duct(n=10) and traditional open operations(n=10) were performed in patients who had gallstones in liver and biliary duct. The hospitalization time, operative complications and post-operative liver functions of the two groups were comparatively studied. Results The operation time and post-operative liver functions of the two groups had no significent differences, but the hospitalization costs and the operative complications of the laparoscopic liver resection and choledochoscopic bile duct exploration group were significantly lower than those of traditional open operation group. Conclusions Laparoscopic left lateral hepatectomy liver resections combined with choledochoscopic bile duct explorations had more advantages than traditional open operation for patients with gallstone in liver and biliary duct, because it could significantly shorten hospital time, and decrease hospital costs and postoperative complications, while it does not prolong operation time and has no adverse effect on liver function.