两种微创术式治疗肝外胆管结石的临床对比分析  

The clinical comparison of two minimally invasive procedures in treating gallbladder calculi with choledocholithiasis

作　　者：颜松龄[1] 吴锦城[1] 黄孕西[1] 纪程宏[1] 

机构地区：[1]厦门市第二医院普外科,福建厦门361000

出　　处：《医学信息（西安上半月）》2006年第7期1183-1186,共4页Medical Information

摘　　要：目的探讨腹腔镜胆囊切除、胆总管切开探查术(LC-CBDE)与内镜下括约肌切开术联合腹腔镜胆囊切除术(EST-LC)两种微创术式治疗肝外胆管结石的临床疗效。方法1999年6月至2006年2月采用两种微创术式治疗肝外胆管结石63例,LC-CBDE组41例、EST-LC组22例。比较两组病人的手术时间、术中出血量、术后肠道功能恢复时间、术后疼痛视觉模拟评分(VAS)、术后住院天数、并发症发生率、结石清除率等指标。结果LC-CBDE组与EST-LC组两组间手术时间、术中出血量、术后肠道功能恢复时间、术后疼痛视觉模拟评分(VAS)、并发症发生率、结石清除率等指标的差异无显著性(P>0.05);LC-CBDE组住院天数较EST-LC组短,差异具非常显著性(P<0.01)。结论LC-CBDE与EST-LC两种微创术式治疗肝外胆管结石均具有创伤小、疼痛轻、出血少、胃肠功能恢复快、并发症少、疗效确切等优点,值得推广,但选择哪一术式需具体分析病情并根据术者腹腔镜手术技巧、内镜操作熟练程度而定。Objective To investigate the two clinical effect of LC--CBDE and EST combined with LC in treating gallbladder calculi with choledocholithiasis. Methods： The two minimally invasive procedures were operated, which have sixty--three cases of gallbladder calculi with choledocholithiasis from Jun 1999 to Feb 2006. The patients were divided into two groups, with LC-- CBDE group 41 cases and EST--LC group 22 cases respectively, and comparing index such as operative time, blood lost, gastrointestinal function restoring time, pain visual analogue scale, postoperative hospitalization, incidence of complication and calculi residual rate. Results： There is no significant difference between the two groups about operative time, blood lost, gastrointestinal function restoring time, pain visual analogue scale, incidence of complication and calculi residual rate（P〉0. 05）. LC-- CBDE group＇s postoperative hospitalization is shorter than EST--LC group with very significant difference （P〈0.01）. Conelasion： Both LC--CBDE and EST--LC are minimally invasive and effective with less pain , less blood lost, less complication and quick restoring. To decide which procedure is appropriate depends on actual state of illness and operator＇s proficiency of laparoscopy and endoscopy.

关 键 词：胆结石 胆总管结石 腹腔镜胆总管探查术 括约肌切开术 内窥镜 胆囊切除术 腹腔镜 

分 类 号：R657.42[医药卫生—外科学] R654.2[医药卫生—临床医学]