胆囊壶腹套扎在腹腔镜胆囊切除术中的临床应用

Clinical Application of Hartmanns Gallbladder Pouch Ligation with Snare in Laparoscopic Cholecystectomy

【目的】探讨胆囊壶腹套扎在腹腔镜胆囊切除术（LC）中的应用效果。【方法】入住本院的复杂性胆石症182例，采用腹腔镜胆囊壶腹套扎（97例A组）和腹腔镜胆囊管解剖闭合（85例B组）。观察两组患者术中出血量、手术时间、LC中转开腹胆囊切除情况和并发症等指标。【结果】B组手术时间、出血量和住院时间显著高于A组（P〈0．01），术中中转开腹手术率和术后复查时胆囊管残留结石发生率高于A组（P〈0．05），两组术后并发症比较无统计学意义（P〉0．05）。【结论】LC术中行胆囊壶腹套扎操作安全，能够有效降低手术难度和并发症的发生。

[Objective]To explore the efficacy of Hartmanns gallbladder pouch ligation with the snare in laparoscopic cholecystectomy（LC）. [Methods]Totally 182 cases of complicated cholelithiasis in our hospital were enrolled in the study. Group A（ n = 97） underwent Hartmanns gallbladder pouch ligation with the snare. Group 13（ n = 85） underwent laparoscopic cystic duct closure after dissect. Blood loss volume, operation time, the conversion of LC to open cholecystectomy and complications in patients of two groups were observed. [Results] The operation time, the volume of blood loss and length of stay in hospital in group B were markedly higher than those in group A（ P 〈0.01）. The conversion rate of LC to open cholecystectomy and the incidence of residual stone of cystic duct in group B were higher than those in group A（ P 〈0.05）. There was no significant difference in the incidence of postoperative complications between two groups （P 〉 0. 05）. [Conclusion] Hartmanns gallbladder pouch ligation with the snare in LC is safe and can effectively decrease the difficulty of the operation and the incidence of complications.