腹腔镜胆囊切除术中Hem-o-lok夹常规处理胆囊管及胆囊动脉的临床研究

Clinical Studies of Hem-o-lok Clips in Laparoscope Cholecystectomy for the Routine Control of Cystic Duct and Cystic Artery

目的:探讨Hem-o-lok夹在腹腔镜胆囊切除术(LC)中处理胆囊管及胆囊动脉的方法及优势。方法:选择2012年6月-2013年12月本科收治的256例择期LC患者作为研究对象,采用随机数字表法将其分成HLC组和TLC组,HLC组术中使用Hem-o-lok塑料结扎夹处理胆囊管、胆囊动脉,TLC组术中使用钛夹处理。比较两组的手术时间、术后引流量、住院时间、住院费用、术后异物不适感和对影像学检查的影响。结果:256例患者均手术成功,无中转开腹,无医源性损伤。两组住院时间及住院费用比较,差异无统计学意义(P>0.05);HLC组手术时间和术后引流量少于TLC组,比较差异均有统计学意义(P<0.01);HLC组术后异物不适感和影响影像学检查方面均优于TCL组,比较差异均有统计学意义(P<0.01)。结论:LC中运用Hem-o-lok夹处理胆囊管及胆囊动脉,操作简单,能缩短手术时间,效果显著优于钛夹,可作为常规处理手段,有临床推广价值。

Objective： To study the method and advantage of ligaturing the cystic duct and cystic artery by using the 121em-o-lok clips in laparoscope cholecystectomy （ LC ） .Method： 256 patients with LC in our department from June 2012 to December 2013 were selected and randomly divided into the HLC group and the TLC group.The HLC group used Hem-o-lok clips to deal with the cystic duct and cystic artery, while the TLC group used titanium clips to ligature the cystic duct and cystic artery.The operative time, postoperative drainage,hospital stays, hospitalization expenses, discomfortableness of foreign＇body after surgery and influence on imageological examination were compared between the two groups.Result： 256 patients＇ operation were successfully completed, there were no conversion to laparotomy and iatrogenic injury.The differences in hospitalization time and hospitalization expenses of the two groups were not statistically significant （ P〉0.05 ） .The operation time and postoperative drainage of the HLC group were less than those of the TLC group, the differences were statistically significant （ P〈0.01 ） .The discomfortableness of foreign body and the influence on imageological examination in the HLC group were better than those in the TCL group, the differences were statistically significant （P〈0.01） . Conclusion： Using Hem-o-lok clips in LC to deal with cystic duct and cystic artery is easy, it can shorten the operation time and the effect is significantly better than titanium clips.It can be used as a routine processing method and it has clinical promotional value.