中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2015年
3期
219-222
,共4页
黄洁%龙奎%许丁伟%孙敏
黃潔%龍奎%許丁偉%孫敏
황길%룡규%허정위%손민
胆总管造口术%腹腔镜%吻合术,Roux-en-Y
膽總管造口術%腹腔鏡%吻閤術,Roux-en-Y
담총관조구술%복강경%문합술,Roux-en-Y
Choledochostomy%Laparoscopes%Anastomosis,Roux-en-Y
目的 比较完全腹腔镜肝总管-空肠吻合术与开腹手术的临床疗效.方法 回顾性分析37例接受腹腔镜肝总管空肠Roux-en-Y吻合术及同期42例接受传统开放肝总管空肠Roux-en-Y吻合术.比较2组患者手术时间、术中出血量、切口长度、术后住院时间、术后胃肠功能恢复时间、切口感染率以及术后胆瘘发生率.结果 观察组患者手术时间为(275.43±12.28) min,高于对照组的(189.12±19.35) min(P =0.031);观察组患者术中出血量为(83.13±6.34) ml,切口长度(5.76±0.7)cm,术后胃肠道恢复时间为(43.33±3.15)h,术后住院时间为(12.65±2.19)d,均低于对照组的(180.37±9.67) ml,(18.51±1.9)cm,(70.45±4.97)h,(22.16±4.61) d(P ＜0.05).观察组中术后切口感染发生率为5.4％,低于对照组(19.07％)(x2=22.12,P＜0.05).两组术后胆瘘发生率无显著性差异.结论 完全腹腔镜肝总管-空肠吻合术安全有效,创伤较小,术后并发症少,适合临床推广应用.
目的 比較完全腹腔鏡肝總管-空腸吻閤術與開腹手術的臨床療效.方法 迴顧性分析37例接受腹腔鏡肝總管空腸Roux-en-Y吻閤術及同期42例接受傳統開放肝總管空腸Roux-en-Y吻閤術.比較2組患者手術時間、術中齣血量、切口長度、術後住院時間、術後胃腸功能恢複時間、切口感染率以及術後膽瘺髮生率.結果 觀察組患者手術時間為(275.43±12.28) min,高于對照組的(189.12±19.35) min(P =0.031);觀察組患者術中齣血量為(83.13±6.34) ml,切口長度(5.76±0.7)cm,術後胃腸道恢複時間為(43.33±3.15)h,術後住院時間為(12.65±2.19)d,均低于對照組的(180.37±9.67) ml,(18.51±1.9)cm,(70.45±4.97)h,(22.16±4.61) d(P ＜0.05).觀察組中術後切口感染髮生率為5.4％,低于對照組(19.07％)(x2=22.12,P＜0.05).兩組術後膽瘺髮生率無顯著性差異.結論 完全腹腔鏡肝總管-空腸吻閤術安全有效,創傷較小,術後併髮癥少,適閤臨床推廣應用.
목적 비교완전복강경간총관-공장문합술여개복수술적림상료효.방법 회고성분석37례접수복강경간총관공장Roux-en-Y문합술급동기42례접수전통개방간총관공장Roux-en-Y문합술.비교2조환자수술시간、술중출혈량、절구장도、술후주원시간、술후위장공능회복시간、절구감염솔이급술후담루발생솔.결과 관찰조환자수술시간위(275.43±12.28) min,고우대조조적(189.12±19.35) min(P =0.031);관찰조환자술중출혈량위(83.13±6.34) ml,절구장도(5.76±0.7)cm,술후위장도회복시간위(43.33±3.15)h,술후주원시간위(12.65±2.19)d,균저우대조조적(180.37±9.67) ml,(18.51±1.9)cm,(70.45±4.97)h,(22.16±4.61) d(P ＜0.05).관찰조중술후절구감염발생솔위5.4％,저우대조조(19.07％)(x2=22.12,P＜0.05).량조술후담루발생솔무현저성차이.결론 완전복강경간총관-공장문합술안전유효,창상교소,술후병발증소,괄합림상추엄응용.
Objective To compare the feasibility and safety of laparoscopic Roux-en-Y choledochojejunostomy versus open Roux-en-Y choledochojejunostomy.Methods From October 2011 to June 2013,37 patients underwent laparoscopic Roux-en-Y choledochojejunostomy (observation group) and 42 underwent open Roux-en-Y choledochojejunostomy (control group).We retrospectively compare the two groups in terms of operation time,intraoperative blood loss,length of incision,postoperative hospital stay,postoperative gastrointestinal function recovery time,incision infection rate and the incidence of biliary fistula after surgery.Results In observation group operation time was (275.43 t 12.28) min,higher than that of control group (189.12 ± 19.35) min (P =0.031),intraoperative blood loss was (83.13 ±6.34) ml,incision length (5.76 ±0.7) cm,postoperative recovery time of gastrointestinal tract of (43.33 ±3.15) h,postoperative hospital stay (12.65 ± 2.19) d,were in favor of the observation group which were respectively (180.37 ±9.67) ml,(18.51 ±1.9) cm,(70.45 ±4.97) h and (22.16 ±4.61) d (t =33.17,36.73,33.17,P ＜ 0.05).Postoperative incision infection rate in observation group was 5.4％,lower than the control group (19.07％) (chi-square =22.12,P ＜ 0.05).Between the two groups there was no significant difference in the incidence of biliary fistula.Conclusions Laparoscopic Roux-en-Y hepatojejunostomy is safe,effective,and less traumatic procedure.
