全腹腔镜下肝叶切除术治疗肝内胆管结石疗效分析(1)
摘 要：目的 探讨全腹腔镜下肝叶切除术治疗肝内胆管结石临床疗效及安全性。方法 回顾性分析我院2015年6月～2016年6月收治的肝內胆管结石患者48例，依据其手术方式分为腹腔镜组与对照组，各24例。腹腔镜组给予全腹腔镜下肝叶切除术，对照组给予传统开腹手术切除肝叶，记录两组患者一般资料，比较两组患者手术时间、术中出血量、术后疼痛程度、术后排气时间、腹腔引流量、住院时间以及结石清除率和复发率。结果 腹腔镜组术中出血量、术后排气时间以及住院时间低于对照组(P<0.05)，腹腔镜组术后疼痛程度评分为(1.80±0.60)分，优于对照组的(3.40±0.50)分，差异具有统计学意义(P<0.05)。两组患者的手术时间、术后腹腔引流量、结石清除率及随访复发率比较差异无统计学意义(P>0.05)。结论 全腹腔下肝叶切除术治疗肝内胆管结石具有良好的疗效及安全性，可降低机体损伤，改善疼痛感受，缩短住院周期，提高生存质量。
关键词：腹腔镜手术；肝叶切除术；肝内胆管结石；传统开腹手术
, 百拇医药
中图分类号：R657.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.028
文章编号：1006-1959(2018)06-0090-03
Therapeutic Effect of Total Laparoscopic Hepatectomy on Intrahepatic Bile Duct Stones
REN Hai-bin
(Department of Hepatobiliary Surgery，People's Hospital of Laizhou City，Laizhou 261400，Shandong，China)
Abstract：Objective To investigate the clinical efficacy and safety of total laparoscopic hepatectomy in the treatment of intrahepatic cholelithiasis.Methods 48 patients with intrahepatic cholelithiasis treated in our hospital from June 2015 to June 2016 were retrospectively analyzed.On the basis of the operation mode is divided into laparoscopic group and control group with 24 cases in each group were given laparoscopic；laparoscopic liver resection，the control group was treated with traditional laparotomy hepatectomy， record the general data of the two groups of patients，compared two groups of patients with operation time，intraoperative bleeding volume， postoperative pain，postoperative exhaust time，peritoneal drainage，hospitalization time，stone clearance rate and recurrence rate.Results The intraoperative bleeding volume， postoperative exhaust time and hospitalization time in the laparoscopic group were lower than those in the control group(P<0.05).The score of postoperative pain in the laparoscope group was(1.80±0.60)scores，which was better than that of the control group(3.40±0.50)，and the difference was statistically significant(P<0.05).There was no significant difference between the two groups of patients' operation time，postoperative intraperitoneal flow rate，stone clearance rate and follow-up recurrence rate(P>0.05).Conclusion Total subhepatic lobectomy has good efficacy and safety in the treatment of intrahepatic bile duct stones，which can reduce body damage，improve pain feeling，shorten the hospitalization cycle and improve the quality of life.
, 百拇医药
Key words：Laparoscopic surgery；Hepatectomy；Intrahepatic cholelithiasis；Traditional open surgery
肝内胆管结石(intrahepatic bile duct stones)是指位于肝管分叉处以上的胆道结石，属于常见胆石症的一种，调查显示其人群发病率约为8%，患者多由于结石梗阻胆道，出现肝内胆管扩张或管腔狭窄，进而引发胆道感染或肝脏损伤等，在我国肝内胆管结石已成为良性胆道疾病死亡的主要原因之一[1，2]。临床治疗可选择肝叶部分切除术，疗效显著，但该手术是较为复杂，并发症发生较多[3]。随着微创手术迅速发展，具有创伤小，出血量少及术后恢复较快等优点，腹腔镜在肝胆外科手术中的优势逐渐凸显。本研究选取我院2015年6月～2016年6月收治的48例肝内肝管结石患者分析疗效，探讨其可行性及安全性。, http://www.100md.com(任海滨)
关键词：腹腔镜手术；肝叶切除术；肝内胆管结石；传统开腹手术
, 百拇医药
中图分类号：R657.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.06.028
文章编号：1006-1959(2018)06-0090-03
Therapeutic Effect of Total Laparoscopic Hepatectomy on Intrahepatic Bile Duct Stones
REN Hai-bin
(Department of Hepatobiliary Surgery，People's Hospital of Laizhou City，Laizhou 261400，Shandong，China)
Abstract：Objective To investigate the clinical efficacy and safety of total laparoscopic hepatectomy in the treatment of intrahepatic cholelithiasis.Methods 48 patients with intrahepatic cholelithiasis treated in our hospital from June 2015 to June 2016 were retrospectively analyzed.On the basis of the operation mode is divided into laparoscopic group and control group with 24 cases in each group were given laparoscopic；laparoscopic liver resection，the control group was treated with traditional laparotomy hepatectomy， record the general data of the two groups of patients，compared two groups of patients with operation time，intraoperative bleeding volume， postoperative pain，postoperative exhaust time，peritoneal drainage，hospitalization time，stone clearance rate and recurrence rate.Results The intraoperative bleeding volume， postoperative exhaust time and hospitalization time in the laparoscopic group were lower than those in the control group(P<0.05).The score of postoperative pain in the laparoscope group was(1.80±0.60)scores，which was better than that of the control group(3.40±0.50)，and the difference was statistically significant(P<0.05).There was no significant difference between the two groups of patients' operation time，postoperative intraperitoneal flow rate，stone clearance rate and follow-up recurrence rate(P>0.05).Conclusion Total subhepatic lobectomy has good efficacy and safety in the treatment of intrahepatic bile duct stones，which can reduce body damage，improve pain feeling，shorten the hospitalization cycle and improve the quality of life.
, 百拇医药
Key words：Laparoscopic surgery；Hepatectomy；Intrahepatic cholelithiasis；Traditional open surgery
肝内胆管结石(intrahepatic bile duct stones)是指位于肝管分叉处以上的胆道结石，属于常见胆石症的一种，调查显示其人群发病率约为8%，患者多由于结石梗阻胆道，出现肝内胆管扩张或管腔狭窄，进而引发胆道感染或肝脏损伤等，在我国肝内胆管结石已成为良性胆道疾病死亡的主要原因之一[1，2]。临床治疗可选择肝叶部分切除术，疗效显著，但该手术是较为复杂，并发症发生较多[3]。随着微创手术迅速发展，具有创伤小，出血量少及术后恢复较快等优点，腹腔镜在肝胆外科手术中的优势逐渐凸显。本研究选取我院2015年6月～2016年6月收治的48例肝内肝管结石患者分析疗效，探讨其可行性及安全性。, http://www.100md.com(任海滨)