专题研究(Monographic Study)

精准肝切除在肝内胆管结石手术治疗中的应用

Published at: 2016年第25卷第2期

肖卫星 1 , 周君 1 , 顾梦佳 1 , 肖广远 1
1 浙江中医药大学附属嘉兴市中医院 肝胆外科,浙江 嘉兴 314000
通讯作者 卫星 肖 Email: xiaowei8038@sina.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.02.006
基金:

摘要

目的:探讨肝内胆管结石患者行精准肝切除术治疗的临床效果。方法:选取2010年3月—2014年12月收治的107例肝内胆管结石患者,随机分为观察组(54例行精准肝切除术)与对照组(53例非规则性肝切除术),比较两组患者的相关临床指标。结果:与对照组比较,观察组手术时间延长(242.3 min vs. 203.4 min),术中出血量(361.3 mL vs. 518.6 mL)、手术当日引流量(131.7 mL vs. 208.6 mL)、术后住院时间(18.1 d vs. 20.9 d)、住院费用(2.2万元 vs. 2.9万元)均减少;术后3、7 d转氨酶峰值降低;总并发症发生率(5.56% vs. 18.87%)与结石复发率(7.41 % vs. 20.75%)降低,差异均有统计学意义(均P<0.05)。结论:肝内胆管结石患者施行精准肝切除术,有利于减轻手术创伤,减少术后并发症,降低结石复发率。


Application of precise hepatectomy techniques in treatment of intrahepatic stones

Abstract

Objective: To determine the clinical efficacy of performing precise hepatectomy technique in surgery for intrahepatic stones. Methods: One-hundred and seven patients with intrahepatic stones admitted from March 2010 to December 2014 were selected, and were randomly assigned into observational group (54 cases undergoing precise liver resection) and control group (53 cases undergoing irregular liver resection). The relevant clinical variables between the two groups of patients were compared. Results: In observational group compared with control group, the operative time was prolonged (242.3 min vs. 203.4 min), but the intraoperative blood loss (361.3 mL vs. 518.6 mL), drainage volume during the day after surgery (131.7 mL vs. 208.6 mL), length of postoperative hospital stay (18.1 d vs. 20.9 d) and hospitalization expenses (22 000 yuan vs. 29 000 yuan) were reduced; the peak levels of transaminases on postoperative day 3 and 7 were decreased; the overall incidence of postoperative complications (5.56% vs. 18.87%) and stone recurrence rate (7.41 % vs. 20.75%) were lower, and all differences had statistical significance (all P<0.05). Conclusion: For patients with intrahepatic stones, performing precise hepatectomy can help alleviate surgical trauma, and reduce postoperative complications and stone recurrence rate.


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引用

引用本文: 卫星 肖, 君 周, 梦佳 顾, 广远 肖. 精准肝切除在肝内胆管结石手术治疗中的应用 [J]. 中国普通外科杂志, 2016, 25(2): 191-196.
Cite this article as: XIAO Weixing, ZHOU Jun, GU Mengjia, XIAO Guangyuan . Application of precise hepatectomy techniques in treatment of intrahepatic stones [J]. Chin J Gen Surg, 2016, 25(2): 191-196.