左肝蒂阻断法行完全腹腔镜左半肝切除术治疗肝内外胆管结石的有效性与安全性

Efficacy and safety of complete laparoscopic left hemi hepatectomy with left pedicle occlusion for intrahepatic and extrahepatic bile duct stones

目的探讨左肝蒂阻断法行完全腹腔镜左半肝切除术治疗肝内外胆管结石的有效性与安全性。方法随机选取我院2019年4月-2020年8月治疗的肝内外胆管结石患者88例为研究对象,按随机数字表法分为对照组和观察组,每组44例。对照组以开腹手术治疗为主,观察组以左肝蒂阻断法行完全腹腔镜左半肝切除术治疗为主,观察比较两组患者术后恢复情况、结石残留率及并发症发生情况。结果观察组术后排气时间、住院时间均短于对照组,VAS评分低于对照组,差异具有统计学意义(均P<0.05)。两组患者的并发症发生率、结石残留率比较,观察组均明显低于对照组,差异具有统计学意义(均P<0.05)。结论与开腹手术比较,左肝蒂阻断法行完全腹腔镜左半肝切除术的有效性、安全性更高,且手术创伤小,患者术后恢复快,值得应用。

Objective To investigate the efficacy and safety of left hepatic pedicle occlusion in the treatment of intrahepatic and intrahepatic biliary stones with complete laparoscopic left hepatectomy.Methods A total of 88 patients with intrahepatic and intrahepatic biliary stones treated in our hospital from April 2019 to August 2020 were randomly selected and divided into groups by random number table method:In the control group(n=44 cases),open surgery was the main method;in the observation group(n=44 cases),the left pedicle occlusion was the main method of complete laparoscopic left liver resection.Postoperative recovery,complications,residual stone rate and other indicators were observed and compared.Results Postoperative exhaust time and postoperative hospitalization days in observation group were shorter than those in control group,and VAS score was lower than that in control group(P<0.05 for both).The incidence of postoperative complications and residual stone rate in the observation group were lower than those in the control group(P<0.05 for both).Conclusion Compared with open surgery,complete laparoscopic left hepatectomy with left pedicle occlusion is more effective and safer,and can restore the health of patients with intrahepatic and intrahepatic bile duct stones as soon as possible,and is worthy of selection.