腹腔镜胆囊切除术中后三角及胆囊管零距离解剖的应用

Application of laparoscopic cholecystectomy in the rear triangle and the cystic duct the zero anatomy

目的探讨腹腔镜胆囊切除术(LC)中后三角及胆囊管零距离解剖的临床价值。方法以我院收治的100例慢性胆囊炎胆囊三角粘连患者为研究对象,其中50例采用后三角及胆囊管零距离解剖行LC(后三角组);另50例采用前三角手术入路行LC(前三角组)。对比两组术中胆漏率、出血率、转开放手术率及总有效率。结果后三角组胆漏率、出血率及转开放手术率均低于前三角组(P<0.05或P<0.01);后三角组总有效率高于前三角组(P<0.05)。结论 LC中后三角及胆囊管零距离解剖能够减少手术胆漏率、出血率及转开放手术率,提高总有效率。该方法具有创伤小、恢复快、安全性高等优点,值得临床推广应用。

Objective To investigate the clinical value of laparoscopic cholecystectomy（LC） in the rear triangle and the cystic duct the zero anatomy. Methods The clinical data of 100 cholecystectomy patients who were the patients with cystohepatic triangle lentor were analyzed retrospectively. Fifty patients received the rear triangle and the cystic duct the zero anatomy（ rear triangle group）, while the other 50 patients received the surgery from the front triangle to road （front triangle group）. The operative bile leakage rate, bleeding rate, turn open operability and overall curative effects of the patients in both groups were compared. Results The bile leakage rate,bleeding rate and turn open operability of the patients in the rear triangle group were lower than those of the patients in the front triangle group （ P 〈 0.05 or P 〈 0.01 ）, and the total effective rate of the rear triangle group was higher than that of the front triangle group （P 〈 0.05）. Conclusion Laparoscopic cholecystectomy in the rear triangle and cystic duct zero anatomy which can reduce op- erative bile leakage rate, the bleeding rate and turn open operability improves overall curative effects. The method which has the advan- tages of small trauma, quick recovery and higher security is worthy of clinical application.