摘要
目的比较改良两孔与传统三孔法腹腔镜胆囊切除术(LC)治疗急性结石性胆囊炎的效果。方法回顾性选取2017年3月至2022年4月由笔者主刀行LC的165例急性结石性胆囊炎患者,按手术打孔数将其分为改良两孔组(56例)与传统三孔组(109例)。采用倾向性评分匹配(PSM)后分析两组的手术及术后恢复情况。结果采用1∶1最邻近匹配法共成功筛选出49对患者。PSM后,两组的手术时间、中转开腹率及术后并发症(胆漏、切口出血)发生率无显著差异(P>0.05);但改良两孔组的术中出血量与术后住院时间均少于传统三孔组,差异具有统计学意义(P<0.05);两组均无胆管损伤、术后腹腔出血或感染的情况。结论针对急性结石性胆囊炎患者,改良两孔法LC是一种可行安全的方法。
Objective To compare the effects of modified two-port and traditional three-port laparoscopic cholecystectomy(LC)in the treatment of acute calculous cholecystitis.Methods A total of 165 patients with acute calculous cholecystitis who underwent LC by the author from March 2017 to April 2022 were retrospectively selected.According to the number of surgical ports,and the patients were divided into modified two-port group(56 cases)and traditional three-port group(109 cases).Propensity score matching(PSM)was used to analyze the operation conditions and postoperative recovery of the two groups.Results A total of 49 pairs of patients were successfully screened by 1∶1 nearest neighbor matching method.After PSM,there were no significant differences in the operation time,conversion to laparotomy rate and incidence of postoperative complications(bile leakage,incision bleeding)between the two groups(P>0.05);but the intraoperative blood loss and postoperative hospital stay in the modified two-port group were less than those in the traditional three-hole group,and the differences were statistically significant(P<0.05);there were no bile duct injury,postoperative abdominal bleeding or postoperative abdominal infection in both groups.Conclusion For the patients with acute calculous cholecystitis,modified two-port LC is a feasible and safe method.
作者
夏咸军
魏胜
濮毅峰
XIA Xianjun;WEI Sheng;PU Yifeng(General Surgery Department,Wuxi City Rehabilitation Hospital,Wuxi 214043;General Surgery Department,the 904 Hospital of the PLA Joint Logistic Support Force,Wuxi 214044,China)
出处
《临床医学研究与实践》
2024年第25期74-77,共4页
Clinical Research and Practice
关键词
腹腔镜胆囊切除术
急性结石性胆囊炎
改良两孔
传统三孔
laparoscopic cholecystectomy
acute calculous cholecystitis
modified two-port
traditional three-port
作者简介
夏咸军(1975-),男,副主任医师,硕士。研究方向:普外科微创技能。
