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腹腔镜有限解剖性肝切除术对中期胆囊癌患者肝功能及预后的影响

Effect of Laparoscopic Limited Anatomic Hepatectomy on Liver Function and Prognosis of Patients with Mid-Stage Gallbladder Cancer.

作者信息

Tong Kun, Kang Yongli

机构信息

Department of Hepatobiliary Surgery, First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing 314000, China.

出版信息

JSLS. 2025 Apr-Jun;29(2). doi: 10.4293/JSLS.2025.00027. Epub 2025 May 30.

Abstract

OBJECTIVE

Explore the effect of laparoscopic limited anatomic hepatectomy (LLAH) on liver function and prognosis of patients with midstage gallbladder cancer.

METHODS

The 82 cases of midstage gallbladder cancer patients admitted to First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University from August 2018 to August 2022 were divided into groups according to surgical methods. Among them, 40 cases underwent traditional laparoscopic anatomic hepatectomy were classified as the traditional group, and 42 cases underwent LLAH were classified as the LLAH group. The perioperative indexes, liver function before and after operation, the complications and prognosis were compared between 2 groups.

RESULTS

Compared with the traditional group, the LLAH group had longer operation time, less intraoperative blood loss and less postoperative hospital stay (>.05). After surgery for 3 months, the levels of albumin (ALB) in 2 groups were higher than before surgery, while the levels of total bilirubin (TBIL), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were lower than before surgery, and the ALB level in LLAH group was higher than traditional group, the levels of TBIL, AST, and ALT were lower than those in traditional group (>.05). The incidence of postoperative complications in LLAH group was lower than that in traditional group (>.05). However, there was no significant difference in the 2-year postoperative survival rate between 2 groups (>.05).

CONCLUSION

The treatment effect of LLAH for patients with midstage gallbladder cancer is significant. It can reduce intraoperative bleeding, shorten postoperative hospital stay, improve liver function, and decrease complications.

摘要

目的

探讨腹腔镜有限解剖性肝切除术(LLAH)对中期胆囊癌患者肝功能及预后的影响。

方法

将2018年8月至2022年8月嘉兴市第一医院(嘉兴学院附属医院)收治的82例中期胆囊癌患者按手术方式分组。其中,40例行传统腹腔镜解剖性肝切除术的患者分为传统组,42例行LLAH的患者分为LLAH组。比较两组的围手术期指标、手术前后肝功能、并发症及预后情况。

结果

与传统组相比,LLAH组手术时间较长,术中出血量较少,术后住院时间较短(P>0.05)。术后3个月,两组白蛋白(ALB)水平均高于术前,总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)及丙氨酸氨基转移酶(ALT)水平均低于术前,且LLAH组ALB水平高于传统组,TBIL、AST及ALT水平低于传统组(P>0.05)。LLAH组术后并发症发生率低于传统组(P>0.05)。然而,两组术后2年生存率差异无统计学意义(P>0.05)。

结论

LLAH治疗中期胆囊癌患者效果显著。可减少术中出血,缩短术后住院时间,改善肝功能,降低并发症发生率。

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