腹腔镜胆囊切除术保留胆囊动脉深支的临床价值分析

doi:10.3969/j.issn.1005-6483.2020.08.014

摘要/Abstract

摘要： 目的探讨腹腔镜胆囊切除术保留胆囊动脉深支的临床价值。
方法 2016年3月～2019年3月我院收治胆囊疾病病人150例，术中确定均存在胆囊动脉深支并依次排序，按随机数字表法分为观察组和对照组，每组各75例。观察组术中仔细分离胆囊动脉深支，并将其保留。对照组将胆囊动脉深支一并夹闭。术后随访12周，比较两组术后2周、4周、12周肝功能指标以及腹胀、腹痛情况，术后4周时比较两组病人生活质量。
结果两组病人均痊愈。观察组手术时间长于对照组，术中出血量多，差异有统计学意义（P<0.05），两组住院时间比较无明显差异（P>0.05）；观察组术后2周及术后4周时门冬氨酸氨基转移酶（AST）、丙氨酸氨基转移酶（ALT）、总胆红素（TBIL）水平低于对照组，差异有统计学意义（P<0.05）;两组术后12周时AST、ALT、TBIL水平比较差异无统计学意义（P>0.05）；观察组术后2周及术后4周腹痛、腹胀发生率少于对照组，差异有统计学意义（P<0.05），术后12周时两组腹痛、腹胀发生率比较差异无统计学意义（P>0.05）;观察组术后4周时随访生活质量评分高于对照组，差异有统计学意义（P<0.05）。
结论腹腔镜胆囊切除术中保留胆囊动脉深支有助于加速康复，降低术后腹痛腹胀的发生率。

关键词: 腹腔镜, 胆囊切除术, 胆囊动脉深支

Abstract: Objective To explore the clinical value of laparoscopic cholecystectomy in preserving the deep branch of gallbladder artery.
Methods From March 2016 to March 2019，150 patients with gallbladder disease were selected，all of whom were confirmed to have deep branches of gallbladder artery during operation，and they were sorted in order.They were randomly divided into observation group and control group according to odd and even method.Each group had 75 cases in each group.In the observation group，the deep branches of gallbladder artery were carefully separated and preserved during the operation.In the control group，the deep branches of the gallbladder artery were clamped .The two groups were followed up for 12 weeks.The liver function indexes，abdominal distention and abdominal pain were compared at 2，4 and 12 weeks postoperatively，and the quality of life of the patients in the two groups were compared at 4 weeks postoperatively.
Results The two groups were cured.Compared with the control group，the operation time of the observation group was longer than that of the control group，and the amount of intraoperative bleeding was relatively more，the difference was statistically significant（P<0.05），and there was no significant difference in the length of stay between the two groups（P>0.05）.The levels of AST，ALT and TBIL in the observation group were significantly lower than those in the control group at 2 weeks，4 weeks after operation（P<0.05）.There was no significant difference in the level of AST，ALT and TBIL between the two groups at 12 weeks（P>0.05）.The incidence of abdominal pain and abdominal distention was significantly less at 2 weeks and 4 weeks（P<0.05），but the incidence of abdominal pain and abdominal distention was similar at 12 weeks（P>0.05）.The quality of life score of the observation group was significantly higher than that of the control group ，after 4 weeks（P<0.05）.
Conclusion Keeping the deep branch of gallbladder artery in laparoscopic cholecystectomy is helpful to accelerate the recovery and reduce the incidence of abdominal pain and distention.

Key words: laparoscopy; , cholecystectomy, deep branch of gallbladder artery

王维帅陈双静. 腹腔镜胆囊切除术保留胆囊动脉深支的临床价值分析[J]. 临床外科杂志, 2020, 28(8): 741-743.

WANG Weishuai, CHEN Shuangjing.. Clinical value of laparoscopic cholecystectomy in preserving the deep branches of gallbladder artery[J]. JOURNAL OF CLINICAL SURGERY, 2020, 28(8): 741-743.

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