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既往有腹部手术史患者行腹腔镜左肝切除术治疗肝内胆管结石的安全性及可行性

Safety and feasibility of laparoscopic left hepatectomy for the treatment of hepatolithiasis in patients with previous abdominal surgery.

作者信息

Liu Lingpeng, Huang Yong, Ding Zigang, Xu Bangran, Luo Dilai, Xiong Hu, Liu Hongliang, Huang Mingwen

机构信息

Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang, China.

出版信息

J Minim Access Surg. 2022 Apr-Jun;18(2):254-259. doi: 10.4103/jmas.JMAS_17_21.

Abstract

BACKGROUND

The aim of the study was to compare the benefits and drawbacks of laparoscopic left hepatectomy (LLH) in patients with previous abdominal surgery (PAS) with those in patients without PAS and confirm the safety and feasibility of LLH as a treatment for patients with hepatolithiasis and PAS.

MATERIALS AND METHODS

This retrospective comparative study included 111 patients who underwent LLH for hepatolithiasis (with PAS, n = 41; without PAS, n = 70) from August 2017 to August 2019. Patients' general information, surgical outcomes, hospital stay duration, hospitalisation cost, post-operative laboratory data and post-operative complications were evaluated.

RESULTS

No statistically significant difference was noted in the post-operative laboratory data between patients with and without PAS (P > 0.05). Longer operative times were required for patients with PAS than for those without PAS (P = 0.025). Hospitalisation cost, hospital stay duration, blood loss, open conversion and post-operative complications were not significantly different between patients with and without PAS (P > 0.05). No cases of mortality were noted.

CONCLUSIONS

LLH is a safe and feasible treatment for patients with hepatolithiasis and PAS.

摘要

背景

本研究旨在比较既往有腹部手术史(PAS)的患者与无PAS的患者行腹腔镜左肝切除术(LLH)的利弊,并证实LLH作为肝内胆管结石合并PAS患者治疗方法的安全性和可行性。

材料与方法

本回顾性比较研究纳入了2017年8月至2019年8月期间因肝内胆管结石接受LLH治疗的111例患者(有PAS,n = 41;无PAS,n = 70)。评估了患者的一般信息、手术结果、住院时间、住院费用、术后实验室数据和术后并发症。

结果

有PAS和无PAS的患者术后实验室数据无统计学显著差异(P > 0.05)。有PAS的患者比无PAS的患者需要更长的手术时间(P = 0.025)。有PAS和无PAS的患者在住院费用、住院时间、失血量、中转开腹和术后并发症方面无显著差异(P > 0.05)。未观察到死亡病例。

结论

LLH是治疗肝内胆管结石合并PAS患者的一种安全可行的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa20/8973501/91ba1fb942fb/JMAS-18-254-g001.jpg

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