摘要
目的探讨腹腔镜与开腹手术在Bismuth-Ⅰ型肝门胆管癌患者中的疗效对比。方法回顾性分析2015年1月至2017年5月收治的Bismuth-Ⅰ型肝门胆管癌患者108例,按照不同术式分为开腹组和腔镜组两组,各54例。数据应用SPSS18.0进行分析,切缘阳性率、并发症等采用χ2检验;术中术后各项指标及肝功能等用(x±s)表示,采用独立t检测;生存率分析采用Kaplan-meier法。P<0.05差异有统计学意义。结果腔镜组出血量、住院时间低于开腹组(P<0.05),腹腔镜组手术时间高于开腹组(P<0.05),两组淋巴清扫数、切缘阳性率和2年内生存率差异无统计学意义(P>0.05);腔镜组肝功能指标TBIL、ALT及AST术后均低于开腹组(P<0.05),Alb高于开腹组(P<0.05);腔镜组并发症发生率1.9%低于开腹组14.8%(P<0.05)。结论采用腹腔镜手术治疗Bismuth-Ⅰ型肝门胆管癌可以有效降低术中出血量,降低术后并发症,缩短患者住院时间,可在临床上进行进一步推广应用。
Objective To evaluate the efficacy of different surgical procedures for Bismuth-Ⅰ hilar cholangiocarcinoma. Methods A retrospective analysis of 108 cases of Bismuth-type Ⅰ porta hepatis bile duct carcinoma from January 2015 to May 2017 were analyzed, according to different operative methods, they were divided into open group and laparoscopy group, each 54 cases. SPSS18.0 was used to analyze, the positive margin, complications were compared with χ~2 test;Intraoperative and postoperative indicators and liver function were expressed by (x±s), and compared with independent t test. The survival rate was analyzed by kaplan-meier method. P<0.05 was statistically significant. Results The amount of blood loss and hospital stay in the laparoscopy group was lower than those in the laparotomy group(P<0.05), while the operation time in the laparoscopic group was higher than that in the laparotomy group(P<0.05). There were no statistically significant differences in the number of lymphatic dissection, positive rate of surgical margin and 2-year survival rate between the two groups(P>0.05). Liver function indexes TBIL, ALT and AST in the laparoscopy group were lower than those in the laparotomy group(P<0.05), and Alb was higher than those in the laparotomy group(P<0.05). The incidence of complications in the laparoscopy group was 1.9%, which was lower than that in the laparotomy group(P<0.05).Conclusion The laparoscopic surgery in the treatment of Bismuth-type Ⅰ porta hepatis bile duct carcinoma can effectively reduce the intraoperative blood loss, reduce the postoperative complications, shorten in-hospital time, which can be further popularized in clinic.
作者
蒋维香
周棱
胡雅娇
Jiang Weixiang;Zhou Ling;Hu Yajiao(West China Hospital,Sichuan University,Chengdu,Sichuan,China)
出处
《中华普外科手术学杂志（电子版）》
2020年第1期78-80,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
关键词
胆管肿瘤
腹腔镜检查
剖腹术
存活率分析
Bile duct neoplasms
Laparoscopy
Laparotomy
Survival analysis
