腹腔镜超声用于复杂肝胆管结石病腹腔镜术

Laparoscopic ultrasonography applicated in laparoscopic operation for complicated hepatolithiasis

目的观察腹腔镜超声(LUS)用于复杂肝胆管结石病腹腔镜术中的价值。方法回顾性分析43例接受腹腔镜手术治疗的复杂肝胆管结石病患者,根据术中是否应用LUS将其分为LUS组(n=18)和未应用LVS(non LVS,NLVS)组(n=25),对比组间一般资料、术中及术后相关情况。结果组间患者性别、既往史、合并症,以及具体术式、中转开腹、手术时间及术中失血量差异均无统计学意义(P均>0.05)。LUS组术后胆道残石率为44.44%(8/18),NLUS组为80.00%(20/25),组间差异有统计学意义(P<0.05)。术中应用LUS是术后胆道残石率较低的独立影响因素[OR=0.20,95%CI(0.05,0.77),P<0.05]。结论在复杂肝胆管结石病腹腔镜术中应用LUS可降低术后胆道残石率。

Objective To explore the value of laparoscopic ultrasonography(LUS)in laparoscopic operation for complicated hepatolithiasis.Methods Data of 43 patients with complicated hepatolithiasis who underwent laparoscopic operation were retrospectively analyzed.According to whether LUS was used during operation,patients were divided into LUS group(n=18)and non LUS(NLUS)group(n=25).The general data,intraoperative and postoperative information were compared between groups.Results No significant difference of terms of gender,past medical history,comorbidity,operation procedure,conversion to laparotomy,operation time,nor of intraoperative blood loss was found between groups(all P>0.05).The postoperative biliary residual stone rates was significant different between LUS group(44.44%[8/18])and NLUS group(80.00%[20/25],P<0.05).The application of LUS was an independent factor for reducing postoperative biliary residual stone rate(OR=0.20,95%CI[0.05,0.77],P<0.05).Conclusion Using LUS in laparoscopic operation for complex hepatolithiasis could reduce postoperative biliary residual stone rate.