腹腔镜与开腹手术治疗腹腔镜胆囊切除术后胆漏的临床疗效比较

Effects of laparoscopic surgery and laparotomy in treatment of bile leakage after laparoscopic surgery

目的探索应用腹腔镜和开腹两种不同的手术方式处理腹腔镜手术后胆漏的临床疗效。方法 2008年1月～2011年12月我科进行腹腔镜胆囊切除并发胆漏的62例患者,随机纳入观察组和对照组。观察组31例患者采用腹腔镜对胆漏进行处理;对照组31例患者行开腹手术进行治疗。观察两组患者的手术时间、术后排气时间、术后疼痛、抗生素使用情况、住院时间及并发症发生率等情况。结果术后观察组平均住院时间(10.22±4.58)天,对照组术后平均住院时间(16.10±5.85)天,差异有显著意义(P<0.05),两组患者术后疼痛情况观察组明显优于对照组,其差异有显著意义(P<0.05),此外手术时间、抗生素使用情况、并发症发生率观察组均优于对照组(P<0.05)。结论相对于开腹探查,腹腔镜在腹腔镜胆囊切除术后胆漏治疗上更具优势,有较好的临床应用价值和推广价值。

Objective To explore the application value of laparoscopic cholecystectomy in laparoscopic treatment of bile leakage.Methods 62 cases treat by LC and bile leakage were divide them into two groups by surgical methods.31 cases were treated with laparoscopic treatment and other 31 cases with open surgery.The surgical time,postoperative discharge time,postoperative pain,antibiotic usage,hospital stay and complication rates were observed.Results The group of 22 cases completed the laparoscopic surgery were without serious complications.The hospital stay of observation group and control group were 10.22±4.58 days and 16.10±5.85 days（P〈0.05）.The operative time,antibiotic use,the complication rate of observation group was better than the control group（P〈0.05）.Conclusion There is a great application value of laparoscopic cholecystectomy in the laparoscopic diagnosis and treatment of bile leakage.