| 引用本文： |
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许志营,徐安安,赵刚,等.3D腔镜系统在腹腔镜联合胆道镜保胆取石术中的应用价值[J].同济大学学报（医学版）,2018,39(1):6-9. [点击复制]
- XU Zhi-ying,XU An-an,ZHAO Gang,et al.Application of three-dimensional laparoscopy in choledochoscopic cholecystolithotomy[J].同济大学学报（医学版）,2018,39(1):6-9. [点击复制]
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| 摘要: |
| 目的 探讨3D腹腔镜联合胆道镜保胆取石术中的应用价值。方法 比较2015年4月至2015年7月期间33例行2D腹腔镜联合胆道镜保胆取石术（2D组）和30例行3D腹腔镜联合胆道镜保胆取石术（3D组）的临床疗效。比较分析患者年龄、性别、BMI指数、结石大小、基础疾病等临床资料及手术时间、胆囊缝合时间、术中出血量、胆囊切口缝合满意度、术后恢复排气时间、术后疼痛程度和住院时间。术后随访18个月，比较两组患者结石复发及胆囊收缩功能。结果 两组手术均成功完成，其中2D组中3例、3D组中4例改行腹腔镜下胆囊切除术（P>0.05），均无中转开腹手术病例。2D组胆囊缝合时间明显长于3D组（P=0.001），胆囊切口缝合满意程度明显低于3D组（P=0.02），两组手术时间、术中出血量以及术后恢复排气时间、术后疼痛程度、住院时间、结石复发率差异无统计学意义(P>0.05）。结论 3D腔镜系统在腹腔镜联合胆道镜保胆取石术中安全、有效，一定程度上可缩短胆囊缝合时间，降低手术难度并提高胆囊缝合质量，可更好作为腹腔镜联合胆道镜保胆取石术的选择。 |
| 关键词: 3D腹腔镜 保胆取石术 胆石病 |
| DOI：10.16118/j.1008-0392.2018.01.002 |
| 投稿时间：2017-10-24 |
| 基金项目:上海市浦东新区卫生系统重点专科建设资助项目（PWZzk2017-10） |
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| Application of three-dimensional laparoscopy in choledochoscopic cholecystolithotomy |
| XU Zhi-ying,XU An-an,ZHAO Gang,YE Rui-qi,HU Hai |
| (Center of Gallstone Disease, East Hospital, Tongji University, Shanghai 200120, China) |
| Abstract: |
| Objective To evaluate the clinical application of three-dimensional(3D) laparoscopy in choledochoscopic cholecystolithotomy. Methods Sixty-three patients underwent laparoscopy-combined choledochoscopic cholecystolithotomy from April 2015 to July 2015, including 33 cases under 2D laparoscopy(2D group) and 30 cases under 3D laparoscopy(3D group).The clinical data including age, gender, body mass index, the size of gallstone, underlying disease, the operative time, the time of gallbladder suture, the volume of the intraoperative blood loss, the satisfaction of gallbladder incision suture, the time for intestine exhaust and length of hospital stay were compared between the two groups. All the patients were followed up for 18 months for the assessment of gallstone recurrence and gallbladder contract function. Results The cholecystolithotomy by laparoscopy combined with choledochoscopy was successfully completed in 26 patients of 3D group and in 30 patients of 2D group(P>0.05). The time of gallbladder suture was significantly shorter and the satisfaction of gallbladder suture was better in 3D group than those in 2D group(P＜0.05). No significant differences were found in the operative time, volume of the intraoperative blood loss, the time for intestine exhaust, length hospital stay, recurrence rate between the two groups(P>0.05). Conclusion 3D laparoscopy combined with choledochoscopy in cholecystolithotomy is safe and effective. It can shorten the operation time and improve the quality of the gallbladder suture to a certain extent. |
| Key words: three-dimensional laparoscopy cholecystolithotomy cholelithiasis |
