3D腹腔镜在胆道手术中应用的初步探索

Preliminary application of 3D laparoscopy in the biliary tract surgery

摘要:

目的??初步探索3D腹腔镜在胆道手术中的临床效果。方法?回顾性分析2015年1月-2016年6月在该院接受腹腔镜胆囊切除+胆总管探查手术治疗的胆道结石患者38例，其中3D腹腔镜手术16例，2D腹腔镜22例，比较分析两组患者手术时间、出血量、术后腹腔引流量，术后引流时间、术后住院时间、住院费用和并发症等的差异。结果?3D组患者手术时间及出血量均优于2D组（P <0.05），两组患者术后引流量、术后引流时间、术后住院时间、住院费用和并发症差异无统计学意义（P >0.05）。2D组有1例患者出现结石残留，术后2个月行经T管窦道胆道镜取石术后痊愈；3D组无结石残留病例。随访2～18个月，两组患者均无结石复发。结论?3D腹腔镜技术使胆道手术更精准、微创，有着广阔的应用前景。

Abstract:

Objective?This paper preliminarily research the clinical effect of 3D laparoscopy in the biliary tract surgery. ?Methods?Thirty-eight patients clinical data of cholelithiasis who accepted laparoscopic cholecystectomy and laparoscopic choledocholithotomy T-tube drainage from January 2015 to June 2016 were retrospectively analyzed,which sixteen patients underwent three-dimensional laparoscopic surgery while twenty-two patients underwent two-dimensional laparoscopic surgery. The operation time, intraoperative blood loss, postoperative drainage,time of drainage, postoperative hospital stay, hospital costs and the incidence of complications were observed in two groups.?Results?There was a statistical significant (P < 0.05) in operation time and intraoperative blood loss between the two groups, 3D group was better than 2D group. There was no statistical significant (P > 0.05) in postoperative drainage, time of drainage, postoperative hospital stay, hospital costs and the incidence of complications between the two groups. One patient of 2D group suffered residual stones and recovered by choledochoscopy through T tube sinus after two months, while no one suffered residual stones in 3D group. There was no recurrence of stones in both groups during the follow-up period which varied from two months to eighteen months.?Conclusions?3D laparoscopy enables biliary tract surgery was more accurate and minimally invasive, it has a widely applicable prospect.