临床普外科电子杂志 ›› 2022, Vol. 10 ›› Issue (4): 58-.

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胆囊后三角解剖入路腹腔镜手术治疗胆囊结石伴慢性胆囊炎患者的疗效分析

  

  1. 淮安市楚州中医院 普外科,江苏 淮安 223200
  • 出版日期:2022-10-01 发布日期:2023-01-13

Laparoscopic cholecystolithiasis with chronic cholecystitis via posterior triangle anatomy

  1. General Surgery Department of Chuzhou Hospital of Traditional Chinese Medicine in Huai'an City, Jiangsu Huai'an 223200, China
  • Online:2022-10-01 Published:2023-01-13

摘要:

目的 探讨胆囊结石伴慢性胆囊炎患者实施腹腔镜手术治疗时选择胆囊后三角解剖入路的治疗效果及安全性。方法 选择2019 年1 月至2022 年4 月淮安市楚州中医院接诊的胆囊结石伴慢性胆囊炎患者120 例,均接受腹腔镜手术治疗,根据入路方式不同分为观察组(60 例)与对照组(60 例)。对照组采取经胆囊三角入路,观察组实施胆囊后三角入路,分别记录并比较两组患者临床指标,检测分析两组患者手术前后炎症水平及免疫功能变化差异,观察统计各组患者术后并发症总发生率。结果 观察组患者手术总时长及术后恢复用时均短于对照组,术中出血量少于对照组(P < 0.05)。术后72h,观察组患者的肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)、白介素6(interleukin 6,IL-6)水平均低于对照组,CD4+、CD8+T 细胞百分比均高于对照组(P < 0.05),差异均有显著性。结论 胆囊结石伴慢性胆囊炎患者接受腹腔镜手术治疗可首选胆囊后三角入路方式,能有效减轻患者因手术引起的炎症反应,且术后并发症少,安全性高。

关键词: 胆囊后三角解剖入路, 腹腔镜手术, 胆囊结石, 慢性胆囊炎

Abstract:

Objective To investigate the efficacy and safety of the posterior triangle approach in laparoscopic cholecystectomy for patients with cholecystolithiasis and chronic cholecystitis. Method From January 2019 to April 2022, 120 patients with cholecystolithiasis and chronic cholecystitis who were admitted by Chuzhou Hospital of Traditional Chinese Medicine in Huai'an City were selected, all of whom received laparoscopic surgery. According to different approaches, the observation group (60 cases) and the control group (60 cases) were divided into two groups. The control group adopted the triangular approach through the gallbladder, and the observation group implemented the posterior triangular approach through the gallbladder. The clinical indicators of the two groups

were recorded and compared, Detect and analyze the difference of inflammatory level and immune function changes between the two groups before and after operation, and observe and count the total incidence of postoperative complications in each group. Result The total operation time and recovery time of patients in the observation group were shorter than those in the control group, and the intraoperative bleeding was less than that in the control group (P < 0.05). At 72h after operation, the TNF-α and IL-6 levels in the observation group were lower than those in the control group, and the percentage of CD4+and CD8+T cells were higher than those in the control group (P < 0.05). Conclusion Laparoscopic cholecystolithiasis with chronic cholecystitis can be performed by the posterior triangle approach, which can effectively reduce the inflammatory reaction caused by surgery, and has less postoperative complications and high safety.

Key words: Posterior trigonometric approach of gallbladder, Laparoscopic surgery, Gallstone, Chronic cholecystitis