高原地区腹腔镜复杂困难胆囊切除术疗效分析

Safety and Efficacy of Complicated Laparoscopic Cholecystectomy in the High Plateau Area

摘要: 目的：探讨复杂困难胆囊胆囊切除术(laparoscopic cholecystectomy, LC)术中的操作技巧及并发症预防。方法：回顾性分析我院2006年1月至2018年12月复杂胆囊结石患者378例，分为腹腔镜组和开放手术组，对两组患者术中胆道损伤、术后并发症进行比较。结果：腹腔镜组在术中胆道损伤、出血量、手术时间、术后引流量、结石残留、切口感染等方面优于开放组，有统计学差异。结论：手术者丰富的临床经验、专业的腹腔镜操作技能和精细解剖Calot三角是手术成功的关键，腹腔镜下进行复杂困难LC术是安全、有效、可行的。

Abstract: Purpose: To investigate the operation technique and prevention of complications in complicated laparoscopic cholecystectomy (LC) versus open surgery. Methods: We retrospectively reviewed 378 cases with complicated gallstones between January 2006 and December 2018 in our hospital. Intraoperative biliary tract injury and postoperative complications were compared between LC group and open surgery group. Results: The intraoperative biliary tract injury proportion, average bleeding volume, operation time, postoperative drainage volume, residual stones rate, incision infection are all lower in the laparoscopic surgery group than the open surgery group (all p < 0.05). Conclusion: LC is superior to open surgery. The clinical experience, laparoscopic skills as well as intraoperative precise anatomy are the keys to successful LC.