摘要
目的:探讨中国人民解放军总医院30年间收治胆道外科良性疾病患者的治疗策略的变化趋势及临床意义.方法:回顾性分析中国人民解放军总医院1985-01/2014-12收治的连续17620例胆道外科良性疾病患者的临床资料,描述其治疗策略整体情况.进而以5年为一个研究小组,描述胆道外科良性疾病治疗策略的30年变化趋势.结果:(1)中国人民解放军总医院30年间收治胆道外科良性疾病患者共17620例,其中男性7404例,女性10216例,平均年龄50.9岁±13.6岁;(2)所占比例最高的疾病依次为胆石症、胆囊息肉和胆道狭窄,分别占78.48%、8.96%和6.35%;(3)从整体治疗策略来看:胆囊良性疾病的微创手术率达82.30%,肝外胆管结石的微创手术率为31.39%,肝内胆管结石的肝脏切除率为61.92%,胆管囊状扩张症的囊肿切除率为95.96%;(4)从变化趋势来看:胆囊良性疾病的微创手术率从36.6%上升至95.6%(P<0.05),肝外胆管结石的微创手术率从0%上升至51.7%(P<0.05),肝内胆管结石的肝脏切除率从33.9%上升至69.5%(P<0.05),胆管囊状扩张症的囊肿切除率从77.8%上升至98.4%(P<0.05).结论:微创技术自兴起以来,在胆道外科良性疾病的治疗中得以飞速发展.而随着对疾病认知的深入和技术的进步,胆道外科良性疾病的治疗策略也在发生着变化.
AIM： To explore the changing trend of treatment strategies for biliary benign disease among 30 years in the PLA General Hospital.METHODS： We retrospectively analyzed the clinical data for 17620 consecutive patients with benign biliary disease treated at the PLA General Hospital between January 1985 and December 2014 according to the inclusion criteria. Taking 5 years as a research group, the change in treatment strategies for benign biliary diseases was described.RESULTS： The PLA General Hospital A total of 17620 patients with biliary benign diseases were treated at the PLA General Hospital over the 30 years, including 7404 male cases and 10216 female cases. The average age was 50.9 ± 13.6 years old. In all patients, the most common diseases were cholelithiasis, gallbladder polyps and biliary stricture, accounting for 78.48%, 8.96% and 6.35%, respectively. The overall rate of minimally invasive surgery was 82.30% for benign gallbladder disease and 31.39% for extrahepatic bile duct stones, the rate of liver resection for hepatolithiasis was 61.92%, and the rate of cyst resection for cystic dilatation was 95.96%. The rate of minimally invasive surgeryincreased from 36.6% to 95.6% for benign gallbladder diseases（P 0.05） and from 0% to 51.7% for extrahepatic bile duct stones（P 0.05）, the rate of liver resection for hepatolithiasis increased from 33.9% to 69.5%（P 0.05）, and the rate of cystic resection for cystic dilatation increased from 77.8% to 98.4%（P 0.05）.CONCLUSION： Minimally invasive techniques have been developed rapidly in the treatment of benign diseases. With the development of technology, the treatment strategies for biliary benign diseases are also changing.
出处
《世界华人消化杂志》
CAS
2016年第9期1449-1455,共7页
World Chinese Journal of Digestology
关键词
胆道外科
良性疾病
治疗
腹腔镜手术
Biliary surgery
Benign diseases
Therapy
Laparoscopic surgery
