摘要
目的探讨肝门阻断在开腹复杂胆囊切除术中的临床应用价值。方法回顾性分析2010年10月~2016年10月我院开腹复杂胆囊切除46例,其中20例行第一肝门阻断辅助下胆囊切除术,其余26例行常规手术切除,比较两组之间临床资料及术后恢复情况。结果所有患者均顺利手术并出院,肝门阻断组患者,阻断次数均为一次,平均阻断时间为4.25±2.14 min,平均手术时间为40.64±7.27 min,显著小于常规手术组(74.15±10.25 min,P<0.001);术中平均失血量23.73±13.44ml,显著小于常规手术组(57.15±11.04 ml,P<0.001)。两组患者术后均未出现严重的并发症。结论对严重的复杂胆囊患者,特别是腔镜探查发现胆囊壁化脓、胆囊三角粘连致密且中转开腹后手术仍然较为困难的情况下,采取开腹手术,并通过术中第一肝门阻断控制出血,有助于术野的清晰显露,方便手术操作,缩短手术时间,是安全有效的。
Objective To evaluate the application of hepatic portal occlusion in the complex operation of gallbladder. Methotis The clinical data of 46 cases who underwent cholecystectomy with hepatic portal occlusion from October 2010 to October 2016 were retrospectively analyzed. 20 cases underwent cholecystectomy with the pringle maneuver and the other 26 cases underwent routine chalecystectomy. Results All the included patients were cured. In the hepatic portal occlusion group, the mean operation time was 40. 64± 7. 27 minutes, cholecystectomy were finished within the first hepatic portal occlusion, and the average blocking time was 4. 25 ＋ 2. 14 minutes; the mean intraoperative blood loss was 23.73 ＋ 13.44 ml. No serious postoperative complications occurred. Conclusion For patients with severe cholecystitis, if exploration confirmed gallbladder with thickened wall or frozen Calot triangle, remove the gallbladder with hepatic portal occlusion is a fast, safe, and effective.
作者
顾炯
彭泉
魏晓明
孙玉年
赵成功
程智礼
GU Jiong;PENG Quan;WEI Xiao-ming(The Second Hospital of Anhui Medical University,Hefei 230601, China)
出处
《肝胆外科杂志》
2018年第3期178-179,221,共3页
Journal of Hepatobiliary Surgery
关键词
肝门阻断
胆囊切除
复杂胆囊
hepatic portal occlusion
open cholecystectomy
complex gallbladder
