腹腔镜胆囊切除术胆囊前三角与胆囊后三角入路对比观察

Contrast Observation of the Former and Posterior Calot's Triangle Approach in Laparoscopic Cholecystectomy

目的:对比采用胆囊前三角与胆囊后三角入路对腹腔镜胆囊切除术的效果区别。方法:将280例LC患者根据有无胆囊粘连分为粘连组与无粘连组。粘连组146例患者中,75例采用胆囊前三角入路,71例采用后三角入路。无粘连组134例患者中,65例采用前三角入路,69例采用后三角入路。结果:粘连组中采用胆囊后三角入路在手术时间、出血量、中转率及术后并发症发生率均低于胆囊前三角入路患者(P<0.05)。粘连组患者两种手术入路手术时间及出血量均高于无粘连组(P<0.05)。两组患者中胆囊前三角入路术后并发症发生率均高于后三角入路(P<0.05)。结论:采用胆囊后三角入路可降低手术难度,避免误伤血管。

Objective：To observer the different effect between the former and posterior calot’s triangle approach in laparoscopic cholecystectomy. Method：280 LC patients were divided into the adhesion group and non-adhesion group according to the gallbladder presence of adhesions.In the adhesion group 75 cases were taken former calot’s triangle approach and 71 cases were posterior calot’s triangle approach.when the amount in the non-adhesion group were 65 and 69. Result：In the adhesion group,the patients who were taken posterior calot’s triangle approach had lower result than the others in the time of operation. amount of bleeding,conversion rate and incidence of complications（P〈0.05）. Two surgical approach in the adhesions patients both were higher than non-adhesion group in the operation time and blood loss（P〈0.05）.In both groups,incidence of complications were higher in the former calot’s triangle approach than that in the posterior calot’s triangle approach（P〈0.05）. Conclusion：Taking posterior calot’s triangle approach can reduce the difficulty,avoiding injure the vessel.