Comparative study of clinical effects of laparoscopic hepatectomy versus open hepatectomy for treating hepatolithiasis
10.3969/j.issn.1671-8348.2014.36.014
- VernacularTitle:腹腔镜肝切除术治疗肝内胆管结石的临床效果对比研究
- Author:
Jianjun LI
;
Bangyu LU
;
Xiaoyong CAI
;
Yubin HUANG
;
Wenqi LU
;
Fei HUANG
;
Xiaojian JIN
;
Yihe YAN
- Publication Type:Journal Article
- Keywords:
hepatolithiasis;
laparoscope;
hepatectomy;
minimally invasive
- From:
Chongqing Medicine
2014;(36):4891-4894
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility and therapeutic effect of total laparoscopic hepatectomy(LH) for treating hepa‐tolithiasis .Methods 75 consecutive patients with hepatolithiasis operatively treated in our hospital from November 2003 to Novem‐ber 2012 were retrospectively analyzed .Among them ,35 cases underwent laparoscopic hepatectomy(LH group) and 40 cases under‐went open hepatectomies(OH group) .The operative modes in the two groups included the left liver lateral lobe resection ,left hemi‐hepatecomy ,common bile duct incision exploration ,choledochoscopy exploration for calculi extraction ,T tube drainage and cholecys‐tectomy .The clinical indicators including the operation time ,intraoperative blood loss ,analgesic drug use situation ,ambulation time , diet recovery time ,postoperative complication rate ,postoperative hospital stay time ,stone clearance rate and recurrence rate were analyzed and compared between the two groups .Results The operation time of the LH group was longer than that of the OH group[(205 .0 ± 40 .9) min vs .(155 .0 ± 26 .6) min ,P< 0 .01] and the postoperative hospital stay time of the LH group was shorter than that of the OH group[(12 .3 ± 2 .6) d vs .(15 .6 ± 4 .3)d ,P< 0 .01] .The intraoperative blood loss of the LH group was slightly more than that of the OH group[(330 .0 ± 259 .7) mL vs .(151 .5 ± 137 .0) mL ,P< 0 .01] .However ,the blood loss of last 10 cases in the LH group was similar to that of the OH group[(81 .0 ± 19 .70)mL vs .(78 .0 ± 22 .0)mL ,P> 0 .05) .The use rate of analge‐sic drugs in the LH group was lower than that of the OH group (0 vs .62 .5% ) .The ambulation time and the diet recovery time in the LH group were shorter than those in the OH group[(1 .5 ± 0 .5)d vs .(3 .6 ± 0 .7)d ,P< 0 .01 ;(2 .4 ± 0 .5)d vs .(4 .0 ± 0 .7) d , P< 0 .01] .No differences between the two groups were found in the occurrence rate of postoperative complications (2 .9% vs . 16 .0% ) ,stone clearance rate(instant clearance rate 91 .4% vs .90% ;final clearance rate 97 .1% vs .100% ) and the opeartion ex‐cellent rate(97 .1% vs .100% ) .No case of perioperative death occurred in the two groups(P > 0 .05) .Conclusion LH combined with choledochoscopy for treating hepatolithiasis is feasible and safe in the patients conforming to the selected standard with an e‐qual therapeutic effect to that of open hepatectomy .LH has the advanteages of minimally invasive surgery such as small incision , less pain ,fast recovery ,less complications ,etc .
