腹腔镜&quot;一钩到底法&quot;快速胆囊切除术的临床应用研究

doi:10.3877/cma.j.issn.1674-0793.2015.04.012

中华普通外科学文献(电子版) ›› 2015, Vol. 09 ›› Issue (04) : 304 -306. doi: 10.3877/cma.j.issn.1674-0793.2015.04.012

所属专题：文献；

论著

腹腔镜"一钩到底法"快速胆囊切除术的临床应用研究

哈恒勇¹^,^†(

), 陈文学¹, 李富荣¹

^1. 741000　甘肃省天水市天水四〇七医院普胸泌尿外科

收稿日期:2015-03-13 出版日期:2015-08-01
通信作者: 哈恒勇

Clinical effect of "one dissector throughout whole operation" in quick laparoscopic cholecystectomy

Hengyong Ha¹^,^†(), Wenxue Chen¹, Furong Li¹

^1. Department of Surgeries, the 407th Hospital of Tianshui City, Tianshui 741000, China

Received:2015-03-13 Published:2015-08-01
Corresponding author: Hengyong Ha
About author:
Corresponding author: Ha Hengyong, Email: hahengyong@126.com

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目的

观察在腹腔镜快速胆囊切除术(LC)中采用"一钩到底法"的临床效果,分析技术要点和优点。

方法

回顾性分析2010年12月至2013年10月间收治的1 303例行LC术的患者,其中685例患者术中应用"一钩到底法"(试验组),618例患者行传统LC术(对照组)。观察两组所用的手术时间、中转开腹手术数、术中胆管损伤数、术后并发症发生情况。

结果

试验组的手术操作时间少于对照组,差异有统计学意义(t=12.58,P<0.05);两组术后均无出血现象,试验组无胆漏发生,且切口感染率低于对照组,但差异无统计学意义(χ²=0.018,P=0.893)。试验组的胆管损伤率(0.29%)和中转开腹率(0.73%)均少于对照组(0.16%、0.32%),但差异无统计学意义。

结论

LC术中应用"一钩到底法"可以缩短手术操作时间,减少并发症的发生率,值得在临床上推广使用。

关键词: 胆囊切除术, 并发症, 一钩到底法, 中转开腹

Objective

To summarize the clinical effect of using "one dissector throughout whole operation" in quick laparoscopic cholecystectomy (LC), and analyze the technical key points and advantages.

Methods

The clinical data of 1 303 patients who underwent LC from December 2010 to October 2013 were retrospectively analyzed. Six hundred and eighty-five patients (study group) were treated with "one dissector throughout whole operation", and 618 patients were treated with routine LC (control group). The operation time, the number of patients converted to open surgery, the number of bile duct injury during operation and incidence of complications were observed.

Results

The operation time of the study group was significantly less than the control group (t=12.58, P<0.05). The two groups had no bleeding after operation, no bile leakage in experimental group, and the wound infection rate in experimental group was lower than the control group(χ²=0.018, P=0.893). The rate of bile duct injury (0.29%) and conversion to open surgery (0.73%) were lower than the control group (0.16%, 0.32%), but there was no statistically significant difference.

Conclusion

The application of "one dissector throughout whole operation" in laparoscopic cholecystectomy can shorten the operation time, reduce the incidence of complications, and is worthy of clinical popularization.

Key words: Cholecystectomy, Complications, One dissector throughout whole operation, Conversion to laparotomy

表1 两组手术情况的比较

组别	例数	手术时间(min,±s)	术中胆管损伤[例(%)]	中转开腹手术[例(%)]
对照组	618	38.05±18.33	2(0.29)	5(0.73)
试验组	685	26.84±13.07	1(0.16)	2(0.32)
t值	?	12.801	0.008	0.802
P值	?	<0.01	0.929	0.370

表1 两组手术情况的比较

组别	例数	手术时间(min,±s)	术中胆管损伤[例(%)]	中转开腹手术[例(%)]
对照组	618	38.05±18.33	2(0.29)	5(0.73)
试验组	685	26.84±13.07	1(0.16)	2(0.32)
t值	?	12.801	0.008	0.802
P值	?	<0.01	0.929	0.370

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