腹腔镜胆囊次全切除术在困难性胆囊切除患者中应用分析.docVIP

腹腔镜胆囊次全切除术在困难性胆囊切除患者中应用分析 　　[摘要] 目的 分析腹腔镜胆囊次全切术在困难性胆囊切除患者中的应用价值。方法 随机选取2012年3月―2015年2月收治的80例困难性胆囊切除患者按随机数字表法分成观察组和对照组，每组各40例。对照组行腹腔镜胆囊全切术，观察组行腹腔镜胆囊次全切术。对比两组手术时间、术中出血量、住院时间、中转开腹率、术后并发症发生率。 结果 观察组手术时间为（72.59±12.33）min，与对照组的（73.68±12.89）min差异无统计学意义（P0.05）；观察组术中出血量为（52.72±10.15）mL，明显少于对照组的（61.88±11.37）mL（P0.05）；观察组中转开腹率、胆道损伤、胆漏、出血发生率分别为0、2.5%、5%、5%，明显低于对照组的10%、15%、22.5%、20%（P0.05）。 结论 对困难性胆囊患者实行腹腔镜胆囊次全切术具有出血量少、并发症发生率低和恢复快的优势，且能有效避免中转开腹的发生。 　　[关键词] 腹腔镜；胆囊次全切术；困难性胆囊切除 　　[中图分类号] R657.4 [文献标识码] A [文章编号] 1674-0742（2015）12（c）-0044-03 　　Application Effect of Laparoscopic Subtotal Cholecystectomy on Patients with Difficulty Cholecystectomy 　　SONG Shu-ya， CHEN Su-yuan 　　Department of Surgery， Qingdao Chengyang District Second People’s Hospital， Qingdao， Shandong Province， 266112 China 　　[Abstract] Objective To analyze the application effect of laparoscopic subtotal cholecystectomy on patients with difficulty cholecystectomy. Methods 80 cases with difficult cholecystectomy admitted from March 2012 to February 2015 were selected and divided into the observation group and the control group with 40 cases in each in accordance with the random number table method. The control group were treated by laparoscopic total cholecystectomy， and the observation group were treated by laparoscopic subtotal cholecystectomy. And the duration of procedure， intraoperative blood loss， length of stay， the rate of conversion to open surgery， and the incidence of postoperative complications were compared between the two groups. Results There was no statistically significant difference between the observation group and the control group in the duration of procedure [（72.59±12.33） min vs （73.68±12.89） min] （P0.05）. The intraoperative blood loss was much less in the observation group than that in the control group [（52.72±10.15） mL vs （61.88±11.37） mL] （P0.05）. The observation group had much lower rate of conversion to open surgery （0 vs 10%）， obviously lower incidence of bile duct injury （2.5% vs