腹腔镜肝切除与开放肝切除治疗多次胆道术后肝内胆管结石的疗效比较

摘要

Objective:Comparing the laparoscopic liver resection and open liver resection in the treatment of intrahepatic bile duct stones with previous multiple biliary operation,to evaluate the feasibility and safety of the laparoscopic liver resection.Methods:A retrospective report included 25 patients who underwent laparoscopic liver resection (LLR) and 32 who underwent open liver resection (OLR) for intrahepatic bile duct stones with previous multiple biliary operation.Results:The operation time of LLR group was longer than that of OLR group (P=0.001),the postoperative hospital stays and postoperative exhausting time of LLR group was shorter than that of OLR group (P=0.025,P=0.045) ,the total cost of hospitalization was higher than that of OLR (P=0.002).There were not statistically significant in the intraoperative blood loss,blood transfusion rate,postoperative drainage,the extubation time of plasma drainage and postoperative complication rate between the two groups.Conclusion:Laparoscopy partial hepatectomy in the treatment of intrahepatic bile duct stones with previous multiple biliary operations are feasible.Compared with open surgery,the laparoscopic liver resection had the advantages in the hospital stay and fast recovery after surgery.%目的:通过腹腔镜和开腹肝切除治疗多次胆道术后肝内胆管结石疗效的比较,探讨腹腔镜肝切除的适用性与安全性.方法:回顾分析四川大学华西医院手术治疗多次胆道术后肝内胆管结石病例57例,其中腹腔镜肝切除25例(LLR组),开腹肝切除32例(OLR组).结果:LLR组手术时间长于OLR组(P=0.001);LLR组术后住院天数及术后肛门排气时间均短于OLR组(P=0.025,P=0.045);LIR组住院总费用高于OLR组(P=0.002),两组术中出血量、术中输血率、术后引流量、术后血浆引流管拔除时间、术后并发症率均无统计学差异.结论:腹腔镜肝切除治疗多次胆道术后肝内胆管结石是可行的,相比传统的开腹手术其具有明显降低住院时间、术后恢复快等优势.