关键词: 腹腔镜胆囊切除术, 胆囊三角, 后三角入路, 钝性冷分离

Abstract:

Objective To investigate the effect of laparoscopic posterior triangular approach combined with blunt cold separation in laparoscopic cholecystectomy. Method From January 2020 to December 2021, 74 patients undergoing laparoscopic cholecystectomy in Suqian Integrated Traditional Chinese and Western Medicine Hospital were selected. All patients were dissected by blunt cold separation method during the operation. According to different surgical approaches, they were divided into the test group (41 cases via the posterior triangle approach of the gallbladder) and the control group (33 cases via the anterior triangle approach of the gallbladder). The basic surgical indicators of the two groups were compared and the complications were counted. Result The operation time (51.37±7.84)min in the test group was shorter than that in the control group (56.85±7.36)min, and the amount of intraoperative bleeding (30.22±5.68)ml was less than that in the control group (34.49±6.30)ml, the difference was statistically significant (P ＜ 0.05). There was no significant difference in gastrointestinal function recovery and discharge time between the two groups (P ＞ 0.05). The conversion rate of the test group (0) was lower than that of the control group (12.12%), and the incidence of surgical complications (2.44%) was lower than that of the control group (15.15%), with statistically significant differences (P ＜ 0.05). Conclusion Laparoscopic cholecystectomy through the posterior triangle approach can better expose the gallbladder and its adjacent relationship with surrounding tissues, facilitate the identification of extrahepatic bile duct structure and variation, combine with blunt cold separation, shorten the operation time, effectively prevent and reduce iatrogenic bile duct injuries, reduce conversion to laparotomy, and is safe and effective. 

Key words: Laparoscopic cholecystectomy, Gallbladder triangle, Rear triangle approach, Passive cold separation