CAJ | 학술논문

目的：探讨内胆管结石用微创切除的治疗效果。方法肝内胆管结石患者280例根据治疗方法的不同分为治疗组180例与对照组100例，对照组进行开腹肝外叶切除术，治疗组采用腹腔镜下微创肝外叶切除治疗。结果所有患者都顺利完成手术，取净结石。2组的手术时间、术中出血量与输血情况对比，差异都无统计学意义(P>0.05)。与对照组相比，治疗组的术后住院时间、拔引流管时间及镇痛药物使用时间明显较低，差异有统计学意义(P<0.05)。2组术后常见的并发症为胆漏、切口感染、胸腔积液、膈下脓肿等，治疗组和对照组的并发症发生率分别为2.2%和10.0%，组间比较差异有统计学意义(P<0.05)。所有患者随访6个月，无死亡病例。结论进展期肝内胆管结石可采用肝叶切除手术治疗，而腹腔镜技术的应用能有效加快患者的恢复，降低并发症发生率。
목적：탐토내담관결석용미창절제적치료효과。방법간내담관결석환자280례근거치료방법적불동분위치료조180례여대조조100례，대조조진행개복간외협절제술，치료조채용복강경하미창간외협절제치료。결과소유환자도순리완성수술，취정결석。2조적수술시간、술중출혈량여수혈정황대비，차이도무통계학의의(P>0.05)。여대조조상비，치료조적술후주원시간、발인류관시간급진통약물사용시간명현교저，차이유통계학의의(P<0.05)。2조술후상견적병발증위담루、절구감염、흉강적액、격하농종등，치료조화대조조적병발증발생솔분별위2.2%화10.0%，조간비교차이유통계학의의(P<0.05)。소유환자수방6개월，무사망병례。결론진전기간내담관결석가채용간협절제수술치료，이복강경기술적응용능유효가쾌환자적회복，강저병발증발생솔。
Objective To investigate the treatment effect of minimally invasive excision in intrahepatic bile duct stones. Methods Ac-cording to different treatment methods, 280 patients with intrahepatic bile duct stones were divided into the treatment group (180 cases) and the control group(100 cases). The control group were given open hepatic lobectomy while the treatment group were given minimally invasive treatment of hepatic lobectomy by laparoscopy. Results All patients had successfully completed surgery and the stones were removed. Compared the operation time,intraoperative blood loss,and blood transfusion of the two groups,and there were no statistically significance (P>0. 05). The postoperative hospitalization,time of drainage tube remove, time of analgestic drug use in treatment group were obviously lower than those in control group,which had statistically significance (P<0. 05). The common postoperative complications of the two groups were bile leakage,wound infection,pleural effusion and subphrenic abscess,et al. The complication rate of treatment group was 2. 2%, while it was 10. 1% in the control group, which had significant difference (P<0. 05). All the patients were followed-up for 6 months, and there was no death in patients. Conclusion Intrahepatic bile duct stones in progress could be treated by hepatic resection surgery. Laparoscopic techniques could accelerate the recovery of patients and reduce the complication rate,and it would become a new treatment option.