摘要
目的观察自制推结器在腹腔镜胆囊切除术(LC)中的应用效果及安全性。方法回顾性分析我院应用自制推结器行LC术的685例患者(观察组)及行统LC术的618例患者(对照组)。记录两组患者所用手术时间、中转开腹手术、术中胆管损伤及术后并发症发生情况。结果观察组平均手术时间(26.84±13.07)min低于对照组(38.05±18.33)min,差异显著(t=12.801,P<0.01);观察组术中胆管损伤率(0.15%)和中转开腹手术率(0.29%)均低于对照组(0.32%、0.81%),但差异不具显著性(t=0.008、0.802,P>0.05);两组患者术后均无出血现象,观察组无胆漏发生,且切口感染率(0.44%)和总体并发症发生率(0.44%)均低于对照组(0.65%、0.81%),但差异不具显著性(χ2=0.018、0.251,P>0.05)。结论 LC术中应用自制推结器是一种简单、实用、安全、经济且容易掌握的手术方法,能有效减少患者术中副损伤、术后并发症,缩短手术操作时间,有益于LC术工作的开展和推广。
Objective To observe the knot pusher in laparoscopic cholecystectomy( LC) in the clinical effect. Methods Retrospective analysis of our hospital 685 cases of application of self-made knot device for LC patients( observation group),and for the LC operation in 618 patients( control group). The operation time of the two groups of patients were recorded,the conversion to open surgery,intraoperative bile duct injury and postoperative complications. Results The average operation time of the observation group was significantly lower than that of the control group( P < 0. 01). The bile duct injury rate and the rate of conversion to laparotomy were lower than the control group,but the difference was not significant( P > 0. 05). The two groups had no bile leakage,and the incision infection rate and overall complication rate were lower than the control group,but the difference was not significant( P > 0. 05).Conclusion Application of self-made knot pusher for LC operation is a simple,practical,safe,economic and easy operation method can effectively reduce the side injury,complications of patients,shorten the operation time,the popularization and development of LC is beneficial to the operation work.
引文
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