腹腔镜胆囊动脉入路与传统入路胆囊切除术的对比分析

Comparative analysis of the effect of laparoscopic cholecystectomy: cystic artery approach and conventional approach

目的探讨分析腹腔镜胆囊动脉入路与传统入路胆囊切除术的临床资料。方法选取2015年3月至2017年5月行腹腔镜胆囊切除术的临床病例240例,根据不同的手术入路方式分为动脉入路组与传统组,动脉入路组患者行腹腔镜下胆囊动脉入路胆囊切除术,传统组患者行腹腔镜下传统入路胆囊切除术,每组各120例。采用SPSS 18.0统计软件对数据进行分析,两组的手术时间、术中出血量、住院时间计量资料以(x珋±s)表示,采用独立t检验,术后并发症的发生率采用χ2检验,以P<0.05为差异有统计学意义。结果动脉入路组手术时间和住院时间分别为(43.8±11.1)min和(6.3±2.1)d,与传统组比较,差异无统计学意义(P>0.05);动脉入路组的术中出血量为(5.2±3.3)ml,明显少于传统组(17.4±7.4)ml,差异有统计学意义(P=0.000);动脉入路组与传统组患者术后并发症发生率分别为2.5%和5.8%,两组差异无统计学意义(P>0.05),但动脉入路组未出现胆管损伤病例。结论腹腔镜下胆囊动脉入路胆囊切除术可精确胆囊三角解剖,避免胆管损伤,降低术后并发症的发生。

Objective To analyze the clinical effect of laparoscopic cholecystectomy by cystic artery approach or conventional approach. Methods The clinical data of 240 patients undergoing LC from March 2015 to May 2017 were analyzed.Of the patients,120 cases were received cystic artery approach treatment(ALC group)and 120 cases were received traditional approach treatment(TLC group).Statistical analysis were performed by using SPSS 18.0 software.Measurement data such as duration of operation,perioperative amount of bleeding and the length of stay in hospital were expressed as mean±standard deviation,and were examined by using t test.Count data,such as postoperative complication rate were examined by usingχ2 test,A P value<0.05 was considered as statistically significant difference. Results There were no significant diffenrence in the duration of operation and the length of stay in hospital between the two groups(P>0.05).the perioperative amount of bleeding were significantly lower in the ALC group(5.2±3.3)ml than in the TLC group(17.4±7.4)ml(P=0.000).The incidence rate of postoperative complications were 2.5%and 5.8%in the ALC group and TLC group respectively,there were no difference between the two groups(P>0.05),butnobile duct injury cases were found in ALC group. Conclusion The technique of Cystic artery approach used in LC can meticulously dissect the Calot's triangle,prevent bile duct injury effectively,and reduce the incidence rate of postoperative complication.