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Rouviere沟引导定位与传统定位腹腔镜胆囊切除术的比较研究
引用本文:胡剑平,毛岸荣,辛海贝,黄河. Rouviere沟引导定位与传统定位腹腔镜胆囊切除术的比较研究[J]. 医学临床研究, 2017, 34(1). DOI: 10.3969/j.issn.1671-7171.2017.01.017
作者姓名:胡剑平  毛岸荣  辛海贝  黄河
作者单位:解放军第八五医院普外科,上海,200052
摘    要:[目的]分析Rouviere沟引导定位腹腔镜胆囊切除术(LC)与传统定位LC手术的效果.[方法]选择2015年4月至2016年4月于我院行腹腔镜胆囊切除术患者108例,将其随机分为对照组和观察组,每组各54例,对照组予以传统定位,观察组予以Rouviere沟引导定位,比较两组治疗后肝功能[总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)],手术时间和并发症率.[结果]术前两组患者肝功能指标TBIL、AST、ALT比较,差异无统计学意义(P>0.05);经LC术后,两组血清TBIL、AST、ALT水平均高于术前,观察组低于对照组,差异均具有统计学意义(均P<0.05).对照组手术时间(67.54±7.42)min显著高于观察组(47.38±5.69)min,差异具有统计学意义(P<0.05).对照组胆漏、胆管损伤各有4例,并发症发生率为14.82%(8/54);观察组有2例胆漏,其并发症发生率为3.70%(2/54),两组比较差异具有统计学意义(P<0.05).[结论]Rouviere沟引导定位LC手术的临床效果优于传统定位LC手术.

关 键 词:胆囊切除术,腹腔镜  胆管/损伤  手术后并发症  对比研究

Comparative Analysis of the Effect of Rouviere Groove Guided Positioning and the Conven tional Positioning in Laparoscopic Cholecystectomy
Abstract:[Objective]To analyze the effect of Rouviere groove guided positioning and conventional positioning in laparoscopic cholecystectomy.[Methods]One hundred and eight cases of laparoscopic cholecystectomy in our hospi-tal from April 2015 to April 2016 were randomly divided into control group and observation group, each group of 54 cases.The control group underwent traditional positioning, the observation group received Rouviere groove guided po-sitioning. Liver function like the total bilirubin (TBIL) ,the aspartate aminotransferase (AST), the alanine amin-otransferase ( ALT) , the operation time and complication rate of the two groups were compared after treatment. [Re-sults]There was no significant difference in TBIL, AST and ALT between two groups before operation ( P>0.05);Af-ter cholecystectomy, the serum TBIL, AST, ALT levels in the two groups were higher than those before operative , the observation group was lower than that in the control group, the difference was statistically significant ( P<0.05) . The operation time of the control group (67.54 ± 7.42) min was significantly higher than that of the observation group (47.38±5.69)min, the difference was statistically significant ( P<0.05). There were 4 cases of bile leakage and bile duct injury in the control group, the complication rate was 14.82% (8/54); The observation group had 2 cases of bile leakage, the incidence of complications was 3.70% (2/54), the difference between the two groups was statisti-cally significant ( P<0.05).[Conclusion]The clinical effect of Rouviere groove guided positioning in laparoscopic cholecystectomy is superior to the conventional positioning operation.
Keywords:Cholecystectomy  Laparoscopic  Bile Ducts/IN  Postoperative Complications  Comparative Study
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