不分离离断胆囊动脉主干左侧入路腹腔镜下胆囊切除的临床效果观察.docVIP

不分离离断胆囊动脉主干左侧入路腹腔镜下胆囊切除的临床效果观察 　　[摘要]目的 探讨不分离离断胆囊动脉主干左侧入路腹腔?R下胆囊切除的临床效果。方法 选择2011年3月～2015年6月共青城市人民医院收治的胆囊结石患者80例，按照随机数字法分为两组，每组各40例。对照组实施常规手术，观察组实施不分离离断胆囊动脉主干左侧入路腹腔镜下胆囊切除术。观察两组患者围术期情况；比较两组患者手术相关情况、术后并发症发生情况及术后恢复情况。结果 观察组分离胆囊时间及手术时间均短于对照组，术中出血量少于对照组，差异均有统计学意义（P 　　[关键词]不分离离断胆囊动脉主干；腹腔镜；胆囊切除 　　[中图分类号] R657.41 [文献标识码] A [文章编号] 1674-4721（2016）11（a）-0027-03 　　Observation of the clinical effect of regardless of the cystic artery with left side of laparoscopic cholecystectomy 　　XIONG Mei-xue 　　Department of General Surgery，Gongqingcheng People′s Hospital，Jiangxi Province，Gongqingcheng 332020，China 　　[Abstract]Objective To investigate the clinical effect of regardless of the cystic artery with left side of laparoscopic cholecystectomy.Methods Eighty patients with gallstone from March 2011 to June 2015 in Gongqingcheng People′s Hospital were selected and divided into two group according to the random number method，with 40 cases in each group.The control group was implemented with conventional surgery，the observation group was given the operation that regardless of the cystic artery with left side of laparoscopic cholecystectomy.Perioperative condition of patients in the two groups was observed；conditions of surgery-related，postoperative complications，postoperative recovery of patients in the two groups were compared.Results Time of isolated gallbladder and operation in the observation group was shorter than the control group，intraoperative blood loss was less than the control group，the differences were statistically significant （P 　　腹腔镜胆囊切除术术中结扎胆囊动脉时需要将胆囊三角钝性分离，辨别胆总管、胆囊管以及肝总管[1-2]，同时了解胆囊动脉走行，作为腹腔镜下胆囊切除术最关键亦是难度最大的步骤，一旦遇到解剖变异者将显著增加手术操作难度甚至导致术后并发症的发生。对于胆囊动脉的处理[3]，如盲目结扎胆囊动脉则有可能导致胆囊动脉损伤而出血。以往研究证实[4-5]，对于腹腔镜胆囊切除困难而中转开腹的患者，有接近60%的患者为术中胆囊动脉的损伤所致。故术中如何有效避免损伤胆囊动脉，对于提高手术质量、增加手术安全性具有重要价值[6]。本研究探讨了不分离离断胆囊动脉主干左侧入路腹腔镜下胆囊切除术在老年急性结石性胆囊炎患者中的应用效果，现报道如下。 　　1资料与方法 　　1.1一般资料 　　选择2011年3月～2015年6月江西省共青城市人民医院收治的胆囊结石患者80例，所有患者均经术前超声检查诊断，并均实施手术治疗后确诊。纳入标准：①年龄60～80岁，且入院后均确诊合并心脑血管疾病或心脑血管疾病相关危险因素者