开腹胆道旁路手术治疗胆管癌的效果分析

摘要

Objective To investigate the? efficacy of open biliary bypass surgery for cholangiocarcinoma.Methods 60 cholangiocarcinoma patients were randomly divided into the treatment group and the control group,the control group received tra-ditional surgical resection,the treatment group received the open biliary bypass surgery.Results All patients successfully com-pleted surgery.The blood loss,postoperative hospital stay,postoperative ambulation time and postoperative flatus time in the treat-ment group were significantly lower than those of the control group(P<0.05),operating time of the 2 groups had no statistically significant difference.The serum total bilirubin values in the 2 groups before the surgery were high,and after the surgery decreased (P<0.05),while the postoperative value of total serum bilirubin in the treatment group were significantly lower than those of the control group(P<0.05).The postoperative adverse reactions in the treatment group were wound infection,pulmonary infection, bile leakage,hypoxemia,intestinal obstruction,which were significantly lower than those of the control group(P<0.05).Patients were followed up for 6 months,the recurrence rate in the treatment group was 0,which was significantly lower than that of the con-trol group 16.7%(P<0.05).Conclusion Open biliary bypass surgery minimally invasive treatment for cholangiocarcinoma has obvious advantages,it can promote functional recovery of bile and reduce the incidence of long-term recurrence rate of postopera-tive complications,and it should be widely applied.%目的：探讨开腹胆道旁路手术治疗胆管癌的效果。方法60例胆管癌患者，根据随机数字表法分为治疗组与对照组，各30例。对照组采用传统手术切除治疗，治疗组采用开腹胆道旁路手术治疗。结果所有患者都顺利完成手术，治疗组的术中出血量、术后住院时间、术后下床活动时间与术后肛门排气时间明显低于对照组（P＜0．05），而2组手术时间对比差异无统计学意义。2组术前的血清总胆红素值都呈现为高位状况，术后都明显降低（P＜0．05），同时术后治疗组的血清总胆红素值明显低于对照组（P＜0．05）；治疗组术后切口感染、肺部感染、胆漏、低氧血症、粘连性肠梗阻等并发症发生率明显低于对照组（P＜0．05）。术后随访6个月，治疗组复发率为0，对照组为16．7％，治疗组复发率明显低于对照组（P＜0．05）。结论开腹胆道旁路手术治疗胆管癌具有明显的微创优势，能促进胆功能的恢复，减少术后并发症的发生与远期复发率，值得推广应用。