摘要
目的探讨有胃切除手术史的患者胆囊良性疾病行腹腔镜手术的风险。方法回顾性分析2010年1月至2015年5月湖州市中心医院腹腔镜胆囊切除术（1aparoscopic cholecystectomy，LC）患者资料。结果与无胃切除手术史的患者相比，胃切除术后患者平均手术时间较非手术患者长（t=15．608，P〈0．05），出血量更多（t=3．061，P〈0．05），而中转率、术中胆道损伤率和术后住院时间比较，差异无统计学意义（P〉0．05）。胃和胆囊手术间隔时间5年以上患者较5年内手术患者手术时间短（t=6．405，P〈0．01）。在经过完善的术前评估后，胃切除术后患者手术中转率明显下降（X^2=15．282，P〈0．01）。结论在完善的术前评估和熟练的手术技巧基础上，LC应用于胃切除术后患者是安全有效的。
Objective To investigate the risk factors of laparoscopic cholecystectomy （LC） in patients with previous gastrectomy. Methods This retrospective study reviewed a database of patients who underwent LC at our hospital during the period of Jan 2010 and May 2015. Results Comparesd with those of no history of gastrectomy the average operation time in patients with previous gastrectomy was longer （ t=15.608, P 〈0.05 ） the intraoperative blood loss was higher （t=3.061, P〈0.05 ）, and the operation time of patients with a long interval （ 〉5 years） between gastrectomy and LC was shorter （ t=6.405, P 〈 0.01 ）. The conversion rate did not differ between the two groups （ P〉0.05 ）, but the conversion rate significantly reduced ＇after a comprehensive preoperative evaluation procedure （X^2=15. 282, P〈0.01 ） . Conclusion LC for benign gallbladder diseases is safe, effective and feasible in patients with a history of gastrectomy, if a comprehensive preoperative evaluation is adopted and in experinced hands.
作者
袁文斌
韦微
张鸣杰
张国雷
周轼瑜
岑峰
慎华平
严强
Yuan Wenbin;Wei Wei;Zhang Mingjie;Zhang Guolei;Zhou Shiyu;Cen Feng;Shen Huaping;Yan Qiang(Department of Hepatobiliary Surgrey,Huzhou Central Hospital,Huzhou 313000,China)
出处
《中华普通外科杂志》
CSCD
北大核心
2018年第10期836-838,共3页
Chinese Journal of General Surgery
基金
浙江省医药卫生平台计划重点资助项目（2015ZDA029）
关键词
胃切除术
胆囊疾病
胆囊切除术
腹腔镜
Gastrectomy
Gallbladder diseases
Cholecystectomy
laparoscopic
