经皮肝穿刺胆道硬镜碎石取石术与开腹肝切除术治疗左肝内胆管结石的疗效分析

Analysis on the Efficacy of Percutaneous Transhepatic Cholangioscopic Lithotripsy and Open Hepatectomy in the Treatment of Left Localized Hepatolithiasis

目的比较经皮肝穿刺胆道硬镜碎石取石术(PTCSL)与开腹肝切除术治疗左肝内胆管结石的临床疗效。方法回顾性分析2016年2月至2018年2月期间来我院进行手术治疗的120例左肝内胆管结石患者的临床资料,其中行PTCSL的60例患者设为观察组,行传统开腹肝切除术的60例患者设为对照组,比较两组的围手术期指标及术后并发症发生情况。结果观察组患者的手术时间显著长于对照组,术中出血量显著少于对照组,平均住院时间显著短于对照组,术后并发症总发生率显著低于对照组,差异均具有统计学意义(P均<0.05)。结论经皮肝穿刺胆道硬镜碎石取石术治疗左肝内胆管结石较之传统开腹肝切除术,可有效降低术中出血量,缩短住院时间,减少并发症发生率,是一种安全、实用的术式。

Objective To compare the efficacy of percutaneous transhepatic cholangioscopic lithotripsy(PTCSL) and open hepatectomy in the treatment of left localized hepatolithiasis.Methods The clinical data of 120 patients with left localized hepatolithiasis who received surgical therapy in our hospital from February 2016 to February 2018 were analyzed retrospectively. 60 patients with PTCSL were set as the observation group, and 60 patients with open hepatectomy were set as the control group. The perioperative indicators and incidence of postoperative complications were compared between two groups. Results The operation time of the observation group was significantly longer than that of the control group, the intraoperative hemorrhage volume was significantly less than that of the control group,the average hospitalization time was significantly shorter than that of the control group, and the total incidence of postoperative complications was significantly lower than that of the control group, with statistically significant differences(P<0.05).Conclusions Compared with open hepatectomy, PTCSL in the treatment of left localized hepatolithiasis can effectively reduce the intraoperative hemorrhage volume, shorten the hospitalization time, and reduce the incidence of complications, which is a safe and practical operation.