摘要
目的探讨腹腔镜手术在成人先天性胆管扩张症治疗中的优势及价值。方法通过回顾分析皖南医学院弋矶山医院2015年6月至2019年1月间收治的26例成人先天性胆管扩张症患者的手术及临床资料,比较腹腔镜组与开腹组术中及术后相关指标差异。结果腹腔镜组15例,开腹组11例,两组均成功完成胆总管囊肿切除+肝管空肠Roux-en-Y吻合术。两组手术时间[(230.27±23.52)min vs(174.18±20.95)min]、术中出血量[(116.87±37.42)mLvs(172.45±27.74)mL]差异均存在统计学意义(分别t=6.284,-4.152,P<0.05);在术后住院时间[(7.25±2.40)d vs(9.93±1.56)d]、引流管拔除时间[(6.61±1.61)d vs(8.89±0.54)d]、胃肠通气时间[(2.90±0.64)d vs(4.35±0.90)d]方面,两组差异也存在统计学意义(分别t=-3.224,-4.374,-4.484,P<0.05)。两组患者术后胆瘘、胰瘘、胆管炎、切口感染、术后出血等总并发症发生率差异无统计学意义(P>0.05)。结论虽然腹腔镜手术治疗成人先天性胆管扩张症手术时间较长,但具有术中出血少、术后恢复快等优势,值得临床推广。
Objective To investigate the advantage and value of laparoscopic surgery for treatment of congenital biliary dilatation in adult patients.Methods The surgical and clinical data of 26 adult patients with congenital biliary dilatation admitted in Yinjishan Hospital of Wannan Medical College from Jun.2015 to Jan.2019 were analyzed retrospectively,and the clinical indexes were compared between the laparoscopic surgery group and the open surgery group.Results There were 15 cases in laparoscopy group and 11 cases in open surgery group.Choledochal cyst excision+Roux-en-Y hepatoenterostomy was successfully performed in all of the 26 patients.The total operation time of the two groups was(230.27±23.52)min vs(174.18±20.95)min,intraoperative blood loss was(116.87±37.42)mL vs(172.45±27.74)mL,and the differences of the two indexes between the two groups were statistically significant(t=6.284,-4.152,respectively P<0.05).The postoperative hospitalization time was(7.25±2.40)d vs(9.93±1.56)d,drainage tube removal time was(6.61±1.61)d vs(8.89±0.54)d,gastrointestinal ventilation time was(2.90±0.64)d vs(4.35±0.90)d,and the differences of these three indexes between the two groups were all statistically significant(t=-3.224,-4.374,-4.484,respectively P<0.05).There was no significant difference in the incidence of postoperative complications such as biliary fistula,pancreatic fistula,cholangitis,wound infection,or postoperative blood loss between the two groups(P>0.05).Conclusion Although laparoscopic surgery for adult congenital biliary dilatation has a longer operation time,it has the advantages of less intraoperative bleeding and quick recovery after surgery,which is worthy of clinical promotion.
作者
程宏亮
胡明华
王传喜
杨玉权
唐伟杰
王光宇
CHENG Hong-liang;HU Ming-hua;WANG Chuan-xi;YANG Yu-quan;TANG Wei-jie;WANG Guang-yu(Department of Hepatobiliary Surgery,Yijishan Hospital,Wannan Medical College,Wuhu,Anhui 241001,China;Department of Hepatobiliary Surgery,the Second People’s Hospital of Wuhu,Wuhu,Anhui 241001,China)
出处
《肝胆胰外科杂志》
CAS
2019年第11期659-662,666,共5页
Journal of Hepatopancreatobiliary Surgery
