CAJ | 학술논문

目的：观察腹腔镜肝切除术治疗左肝内胆管结石的临床疗效。方法根据结石及肝脏病变程度将45例左肝内胆管结石患者随机分为腹腔镜肝切除术组（LH组）23例和开腹肝切除术组（OH组）22例。观察两组患者手术时间、术中出血量、术后止痛药使用情况、下床活动时间、恢复饮食时间、术后并发症、术后住院时间、结石清除率和复发率等因素。结果与OH组比较，LH组患者的手术时间、术后住院时间、术中出血量、术后止痛药使用率、下床活动和进食时间、术后并发症发生率，差异有统计学意义（P<0.05）；而两组患者在结石清除率（即时清除率和最终清除率）差异无统计学意义（P>0.05）。结论腹腔镜肝切除术治疗肝内胆管结石具有切口小、痛苦轻、恢复快、并发症少等微创手术的优势。
목적：관찰복강경간절제술치료좌간내담관결석적림상료효。방법근거결석급간장병변정도장45례좌간내담관결석환자수궤분위복강경간절제술조（LH조）23례화개복간절제술조（OH조）22례。관찰량조환자수술시간、술중출혈량、술후지통약사용정황、하상활동시간、회복음식시간、술후병발증、술후주원시간、결석청제솔화복발솔등인소。결과여OH조비교，LH조환자적수술시간、술후주원시간、술중출혈량、술후지통약사용솔、하상활동화진식시간、술후병발증발생솔，차이유통계학의의（P<0.05）；이량조환자재결석청제솔（즉시청제솔화최종청제솔）차이무통계학의의（P>0.05）。결론복강경간절제술치료간내담관결석구유절구소、통고경、회복쾌、병발증소등미창수술적우세。
Objective To observe the clinical effects of laparoscopic hepatectomy in the treatment of left localized hepatolithiasis. MethodsThis retrospective study enrolled forty-five patients with Laparoscopic hepatectomy between Nov. 2010 and Nov. 2013.Twenty-three cases of laparoscopic hepatectomy,twenty-two cases of open hapatectomy for intrahepatic stone were included according to stones and hepatic pathological changes. Subsequently,the infl uence of the two approaches on the parameters that including operative time and intraoperative bleeding, and postoperative situationsthat including paregoric usage,activity time,the diet restore time,complications,hospital stays,stone clearance and recurrence rate were comparatively analyzed.Results Compared with the open hapatectomy,there was statistics significance(P<0.05) of two groups between surgery time,blood lost,hospital stays,paregoric usage,stone recurrence rate and complications. However,there was no statistics signifi cance(P>0.05) of two groups between stone clearance(Instant clearance and the fi nal clearance).Conclusion Laparoscopic hepatectomy showed advantages of minimally invasive surgery,such as small incision,less pain,fast recovery,less complications etc.