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

Comparative observation between anterior Calot triangle and posterior Calot triangle approaches in laparoscopic cholecystectomy

目的探讨腹腔镜胆囊切除术胆囊前三角与胆囊后三角入路效果情况。方法分析普外科160例患者的临床资料,依据腹腔镜胆囊切除术手术入路措施不同进行临床分组,分为入路Ⅰ组(胆囊前三角入路)和入路Ⅱ组(胆囊后三角入路),各80例。观察两组患者手术时间、术中出血量情况,中转开腹、术后出血以及胆漏发生率情况。结果入路Ⅱ组患者手术时间、术中出血量、中转开腹、术后出血、胆漏发生率均优于入路Ⅰ组,差异均有统计学意义(P<0.05)。结论腹腔镜胆囊切除术胆囊后三角入路创伤小、出血少,术后并发症少,值得临床推广应用。

Objective To investigate effects of anterior Calot triangle and posterior Calot triangle approaches in laparoscopic cholecystectomy. Methods Clinical data of 160 patients in department of general surgery were analyzed. Patients were divided by different surgical approaches into approach I group （anterior Calot triangle approach） and approach Ⅱ group （posterior Calot triangle approach）, with 80 cases in each group. Operation time, intraoperative bleeding volume, conversion to laparotomy, postoperative hemorrhage, and incidence of bile leakage were observed in the two groups. Results The approach Ⅱ group had all better operation time, intraoperative bleeding volume, conversion to laparotomy, postoperative hemorrhage, and incidence of bile leakage than the approach I group. Their differences all had statistical significance （P〈0.05）, Conclusion Posterior Calot triangle approach in laparoscopie cholecystectomy has the advantages of small invasion, few hemorrhage and postoperative complications. This method is worthy of clinical promotion and aPPlication.