腹腔镜次全胆囊切除术治疗复杂性胆囊结石可行性的研究.doc

腹腔镜次全胆囊切除术治疗复杂性胆囊结石可行性的研究 　　[摘要] 目的 探析腹腔镜次全胆囊切除术治疗复杂性胆囊结石可行性。方法 整群选择该院2012年1月―2015年5月收治97例复杂性胆囊结石患者作为研究对象，随机分为两组。对照组行腹腔镜逆行胆囊切除术，观察组行腹腔镜次全胆囊切除术，比较两组手术相关指标、术后恢复情况、并发症发生率。结果 观察组各项手术指标均小于对照组，比较差异有统计学意义（P0.05）；观察组住院时间为（5.8±1.0） d，短于对照组（6.2±0.8） d，比较差异有统计学意义（P0.05）。 结论 次全胆囊腹腔镜切除术治疗复杂性胆囊结石具有手术时间短、术中出血量少与补液量少等优点，住院时间更短，有较大可行性与推广价值。 　　[关键词] 复杂性胆囊结石；三角区；解剖；胆管损伤 　　[中图分类号] R83 [文献标识码] A [文章编号] 1674-0742（2015）09（a）-0026-02 　　Laparoscopic Subtotal Cholecystectomy in the Treatment of Complicated Gallbladder Stones Feasibility Study 　　YAN Jun-yi 　　Department of Surgery in Zhumadian Maternal and Child Health Hospital， Zhumadian， Henan Province， 463000 China 　　[Abstract] Objective Analysis of laparoscopic subtotal cholecystectomy in the treatment of complicated gallstone feasibility. Methods In our hospital from January 2012 to May 2015 in our hospital 97 cases of complicated gallstone patients as the research object， randomly divided into two groups. The control group underwent laparoscopic retrograde cholecystectomy， the observation group underwent laparoscopic subtotal cholecystectomy， compared two groups of operation related indicators， postoperative recovery， complication rate. Results In the observation group， the operation indexes were smaller than the control group， the difference was statistically significant （P0.05）； the observation group hospitalization time was （5.8±1） d， shorter than the control group （6.2±0.8） d， the difference was statistically significant （P0.05）. Conclusion Subtotal laparoscopic gallbladder surgery in treatment of complicated gallbladder stone with shorter operation time， intraoperative bleeding， less and less the amount of fluid advantages， shorter hospital stay， has feasibility and promotion value. 　　[Key words] Complicated gallstone； Triangular area； Anatomy； Bile duct injury 　　胆囊结石发病率较高，在10%～20%，致病原因包括胆汁化学成分改变、细菌感染、胆汁淤积等[1]。复杂性胆囊结石指胆囊结石患者胆囊发生水肿、萎缩或严重三角粘连或胆囊管、胆囊动脉变异，由于解剖结构难以分离，因此手术难度大幅增加，胆管及血管受到损伤几率也随之增加[2]。而腹腔镜胆囊切除术凭借其术野清晰、创伤轻、解剖结构尽收眼底等