腹腔镜下治疗胃十二指肠疾病42例临床分析

Clinical analysis of laparoscopic treatment in gastroduodenal diseases

目的探讨腹腔镜下手术治疗胃十二指肠疾病的临床价值、手术方法、适应证及优缺点。方法腹腔镜手术组为胃十二指肠疾病患者42例,其中胃壁良性肿瘤切除术14例、胃十二指肠溃疡穿孔修补术11例、胃大部切除术10例、高选择性迷走神经切断术7例,应用腹腔镜技术行手术治疗。对照组为不经过腹腔镜进行同类型手术治疗的患者,每种类型手术患者10例。统计手术时间、住院时间、术中出血量和并发症。结果腹腔镜手术组肿瘤切除、穿孔修补、胃大部切除和迷走神经切断术的手术时间、术中出血量、住院时间和并发症等指标,均显著优于同类型手术的对照组。结论腹腔镜下治疗胃十二指肠疾病具有创伤小、手术时间短、术后恢复快及术后并发症少的特点。胃壁良性肿瘤切除、胃十二指肠溃疡穿孔修补、胃大部切除、高选迷走神经切断均是腹腔镜手术治疗的适应证。

Objective To investigate the clinical value, methods and indications of laparoscopic operation on gastroduodenal diseases. Methods Laparoscopic operation was employed on 42 patients of gastroduodenal diseases, including benign gastric tumor resection (14 cases), perforated gastroduodenal ulcer repair (11 cases), partial stomach resection (10 cases), highly selective vagotomy(7 cases). The routine surgery was performed on 40 patients matched in disease type with those employed laparoscopic operation, 10 of each type of disease. The operation time, length of stay, bleeding volume and postoperative complications were analysed. Results The parameters mentioned above in laparoscopic operation group showed a significant difference with those in routine operation group (P<0.01). Conclusion The advantages of laparoscopic treatment in gastroduodenal diseases are small wound, short operation time, quick recovery, and less complications. Its indications are including benign gastric tumor resection, perforated gastroduodenal ulcer repair, partial stomach resection, and highly selective vagotomy.