腹腔镜与开腹 Roux-en-Y 胆肠吻合术：单中心经验并文献复习。

Laparoscopic Versus Open Roux-en-Y Choledochojejunostomy: A Single-institute Experience With Literature Review.

机构信息

Department of Liver & Laparoscopic Surgery, Center of Digestive & Vascular Surgery.

The Second Department of General Surgery, The First People's Hospital of Kashi, Kashi, Xinjiang Uyghur Autonomous Region, China.

出版信息

Surg Laparosc Endosc Percutan Tech. 2020 Nov 25;31(3):321-325. doi: 10.1097/SLE.0000000000000873.

DOI:10.1097/SLE.0000000000000873

PMID:33252575

Abstract

OBJECTIVES

The current clinical study aims to compare the clinical efficacy of open choledochojejunostomy (OCJ) and laparoscopic choledochojejunostomy (LCJ) in patients with benign and malignant biliary tract disorders.

PATIENTS AND METHODS

The clinical data of 40 consecutive patients who underwent either OCJ or LCJ from January 2015 to February 2017 were retrospectively analyzed. The clinical parameters analyzed include baseline information, intraoperative characteristics, and postoperative clinical outcomes. The patients were divided into OCJ group and LCJ group based on the surgical approach performed.

RESULTS

Of 40 patients during the study period, 15 underwent LCJ and the remaining 25 patients underwent OCJ. The mean operative time was slightly longer in the LCJ group (323.53±150.30 min) than the OCJ group (295.38±130.34 min) (P=0.945); intraoperative blood loss in 2 groups were similar (179.17 vs. 164.67 mL, P=0.839). Although hospital stay was significantly shorter in the LCJ group (8.33±2.1 d) compared with the OCJ group (19.24±4.2 d) (P<0.001). Biliary leakage is the most common complication after OCJ; no complication was experienced in the LCJ group.

CONCLUSIONS

LCJ is a feasible and safe option for patients undergoing choledochojejunostomy.

摘要

目的

本临床研究旨在比较开腹胆肠吻合术（OCJ）和腹腔镜胆肠吻合术（LCJ）治疗良恶性胆道疾病的临床疗效。

患者与方法

回顾性分析 2015 年 1 月至 2017 年 2 月期间 40 例连续接受 OCJ 或 LCJ 的患者的临床资料。分析的临床参数包括基线信息、术中特征和术后临床结果。根据手术方式将患者分为 OCJ 组和 LCJ 组。

结果

在研究期间的 40 例患者中，15 例接受 LCJ，其余 25 例接受 OCJ。LCJ 组的平均手术时间（323.53±150.30 分钟）略长于 OCJ 组（295.38±130.34 分钟）（P=0.945）；两组术中出血量相似（179.17 与 164.67 毫升，P=0.839）。尽管 LCJ 组的住院时间明显短于 OCJ 组（8.33±2.1 天）（P<0.001）。OCJ 后最常见的并发症是胆漏；LCJ 组无并发症发生。