直视微创胆道手术367例临床研究

Clinical Study on Open Microtrauma Biliary-tract surgery in 367 Cases

目的 探索直视微创胆道手术方法和技巧 ,以减小胆道手术创伤和加速术后康复。方法 应用普通手术器械和深部手术拉钩 ,完成微创直视胆道手术。结果 完成单纯胆囊切除术 3 2 0例 ,胆囊切除同时胆总管切开探查取石T型管引流术 3 9例 ,胆总管再次手术 8例。微创切口 :2 5cm 9例 ,3cm 3 3 5例 ,4cm 11例 ,扩大为小切口 4cm以上 12例。 3 67例患者无死亡 ,无感染 ,无胆道损伤和术后出血 ,治愈率 10 0 %。结论 此术式适应症广 ,手术时间短 ,出血少 ,恢复快 ,合并症发生率低 ,痛苦微小 ,成本低 。

Objective To abate the operative trauma and the post-operative pain that was researched on the technique program of biliary tract surgery. Methods Cholecystectomy was performed in 367 cases to explore the biliary tract with stone released and T tube drainage in 39 cases,choledochotomy was performed once more in 8 cases.Results The surgery was successfully performed with microincision(2.5～4cm)in 355 out of 367 cases(96.7%),miniincision(≥4.1cm)in 12 cases (3.3%)and the average operative time was short.There was no bile duct injury and no operative death,no post operative bleeding. Conclusion With this novel approach,biliary tract surgery could be safely and quickly performed with micro incision and painlessness,the authors have called this procedure'a microtrauma biliary tract surgery(MBS)'.