腹腔镜左肝切除术治疗左肝内胆管结石的临床疗效研究.docx

腹腔镜左肝切除术治疗左肝内胆管结石的临床疗效研究

劳莅枫沙洪存洪晓明

[关键词]?左肝内胆管结石；腹腔镜；左肝切除术；结石复发；倾向性评分匹配

[中图分类号]?R615??????[文献标识码]?A??????[DOI]?10.3969/j.issn.1673-9701.2024.11.006

Clinical?efficacy?of?laparoscopic?left?hepatectomy?for?left?intrahepatic?bile?duct?stones

LAO?Lifeng，?SHA?Hongcun，?HONG?Xiaoming

Department?of?Hepatobiliary?Surgery，?Yinzhou?District?Second?Hospital，?Ningbo?315100，?Zhejiang，?China

[Abstract]?Objective?To?compare?the?clinical?efficacy?of?open?and?laparoscopic?left?hepatectomy?for?the?treatment?of?left?intrahepatic?bile?duct?stones.?Methods?The?clinical?data?of?136?patients?treated?with?hepatectomy?admitted?to?the?Department?of?General?Surgery?of?the?Second?Hospital?of?Yinzhou?District，?Ningbo?from?January?1，?2016?to?January?1，?2022?were?retrospectively?collected.?132?patients?treated?with?left?hepatectomy?were?included，?and?the?propensity?score?matching?method?was?used?to?perform?1∶1?matching?between?the?open?left?lobe?hepatectomy?（OLH）?and?laparoscopic?left?lobe?hepatectomy?（LLH）?groups.?Forty-seven?patients?were?matched?in?each?group.?The?main?observations?were：?operative?time，?intraoperative?bleeding，?intraoperative?blood?transfusion?rate，?postoperative?hospital?stay，?complication?rate，?biliary?fistula?rate，?stone?removal?rate?and?stone?recurrence?rate.?Results?The?LLH?group?had?a?shorter?postoperative?hospital?stay，?a?lower?postoperative?complication?rate??and?a?lower?postoperative?biliary?fistula?rate?（P0.05）.?There?was?no?statistically?significant?difference?in?the?initial?stone?removal?rate，?final?stone?removal?rate?and?stone?recurrence?rate?between?the?two?groups.?Multifactorial?analysis?showed?that?open?surgery?and?postoperative?complications?were?independent?risk?factors?for?prolonge?postoperative?hospital?stay.?Open?surgery?was?an?independent?risk?factor?for?postoperative?biliary?fistula;?left?extrahepatic?lobectomy，?postoperative?biliary?fistula?and?combined?multiple?stones?were?independent?risk?factors?for?stone?independent?risk?factors?for?recurrence.?Co