数字胆道系统在复杂胆石症手术中的应用

Application of digital biliary tract system in the operation of complex cholelithiasis

目的探讨数字胆道系统在复杂胆石症微创手术中的临床应用价值。方法纳入2018年4月至2019年7月间收治的复杂胆石症病人41例,随机分为实验和对照两组,实验组进行肝胆建模,导入数字胆道系统,应用于术前评估、手术仿真、制订碎石取石方案和术中指导;两组均采用微创手术。超声或CT复查结石残留和复发情况。结果实验组术中所见胆道及结石均与数字胆道系统中所见吻合,手术方式与术前模拟、规划均一致;手术时间(160.10±78.82)min,术中出血量(2.95±2.28)ml,肠道恢复时间(1.13±0.70)d,均少于对照组,无围手术期严重并发症;无结石残留和复发。对照组有2例结石残留,1例消化道出血和2例结石复发。结论数字胆道系统对于复杂胆石症微创手术有较好的指导意义和应用价值,能减少术中出血,缩短手术时间和肠道恢复时间,安全高效。

Objective To explore the clinical application value of digital biliary system in minimally invasive surgery for complex gallstone disease.Methods 41 patients with complex cholelithiasis were selected from April 2018 to July 2019.They were randomly divided into an experimental group and a control group.In the experimental group,the hepatobiliary model which established by their CT data was introduced to the digital biliary tract system,and then were applied in preoperative evaluation,surgical simulation,and lithotripsy extraction plan for intraoperative guidance.Minimally invasive surgery was performed on the two groups.Reexamination of stones and recurrence were detected by ultrasound or CT.Results The biliary tract and stones in the experimental group were consistent with those in the digital biliary system.The actual surgical method was consistent with the preoperative simulation and planning.The mean operation time was(160.10±78.82)min,the intraoperative bleeding volume was(2.95±2.28)ml,and the intestinal recovery time was(1.13±0.70)days,all were less than those in the control group.No severe perioperative complications,residual stones and recurrence occurred.In the control group,there were 2 cases of residual stones,1 case of gastrointestinal bleeding,and 2 cases of recurrence of stones.Conclusions The digital biliary system showed good guiding significance and application value for minimally invasive surgery for complex cholelithiasis.It could decrease the operation time and intraoperative bleeding and shorten intestinal recovery time and would be safe and efficient.