【摘要】 目的:探讨腹腔镜胆总管探查术中应用胆囊管汇入部微切开的临床价值。方法:将120例胆囊结石伴胆总管结石患者分为两组,其中52例经胆囊管汇入部微切开行腹腔镜胆总管探查术(观察组),68例经胆总管切开行腹腔镜胆总管探查术(对照组),对比两组手术情况、临床疗效及安全性。结果:两组手术时间差异均无统计学意义(P>0.05),但观察组术后肛门排气时间、带管时间及住院时间均短于对照组(P<0.05);观察组无胆漏发生,与对照组[13.24%(9/68)]相比差异有统计学意义(P<0.05)。结论:在严格掌握适应证的情况下,腹腔镜胆总管探查术中应用经胆囊管汇入部微切开入路具有较好的安全性与有效性,可降低胆漏发生率,缩短术后康复时间。更多还原

【Abstract】 Objective:To investigate the clinical value of the transcystic approach with micro-incision of the cystic duct and its confluence part in laparoscopic common bile duct exploration.Methods:One hundred and twenty patients of cholecystolithiasis with choledocholithiasis were divided into two groups:52 patients underwent transcystic approach with micro-incision of the cystic duct and its confluence part in laparoscopic common bile duct exploration as the observation group,68 patients underwent laparoscopic choledochotomy in laparoscopic common bile duct exploration as the control group,the operation condition,clinical efficacy and safety of the two groups were compared.Results:The operative time between the observation group and control group were not significantly different(P> 0.05),but the anal exhaust time,indwelling catheter time and hospital stay in observation group were significantly lower than those in the control group(P < 0.05).There was no bile leakage in observation group,which was significantly lower than 13.24%(9/68) in the control group(P < 0.05).Conclusions:Transcystic approach with micro-incision of the cystic duct and its confluence part in laparoscopic common bile duct exploration is safe and effective with selected indications,it can reduce the incidence of bile leakage and shorten recovery time after surgery.更多还原