腹腔镜与开腹手术行肝切除的对比研究

目的探讨腹腔镜肝切除(LH)的安全性和实用性。方法将行肝切除的80例病人,分入腹腔镜组(LH组)和开腹肝切除组(OH组),比较两组手术病人的平均切口长度、手术时间、麻醉时间、术中出血量、术后禁食时间、术后止痛药用量、术后住院天数、有无并发症及术后血象白细胞和中性粒细胞及肝功能的变化。结果切口长度、禁食时间、止痛药用量、术后住院天数及白细胞和中性粒细胞比例的升高LH组明显小(少)于OH组(P0.01);术后血清谷丙转氨酶(ALT)及血清总胆红素(TBIL)水平两组差异无统计学意义(P0.05);LH组手术时间、麻醉时间长于OH,但差异无统计学意义(P0.05);LH组术后出血1例,胆漏1例;OH组发生出血1例。结论在严格掌握手术适应证前提下,与OH相比,LH是安全的,而且创伤更小。

Laparoscopic versus open hepatectomy

Objective To explore the safety and practicality of laparoscopic hepatectomy （LH）. Methods Eighty patients were divided into LH group or open hepatectomy （OH） group randomly. Clinical data of patients of two groups were compared, which included length of incision, surgical and anesthetic duration, intraoperative blood loss, postoperative eating date, dosage of painkiller, hospital stay, complication, WBC and N, and liver functions. Results The mean of data of LH group was significantly less than that of OH group in such markers as length of incision, eating date, dosage of painkiller, hospital stay, WBC and neutrophil （P 〈 0. 01 ）. Postoperative ALT and TBIL levels in two groups were of no significant difference （P 〉 0.05 ）. Surgical and anesthetic durations of LH group were slightly longer than those of the OH group, but without statistical significant difference （P 〉 0. 05 ）. There was 1 bleeding in each group and 1 bile leakage in LH group only. Conclusion Compared with OH, LH is as safe, but is much more microinvasive.