腹腔镜与开腹胆总管切开取石的对比研究(附176例报告)  

A comparative study on choledocholithotomy by open and laparoscopic surgery(A report of 176 cases)

作　　者：殷良春[1] 周晓初[2] 熊沛[2] 

机构地区：[1]广东省汕头大学医学院,515063 [2]广东省深圳市北京大学深圳医院腔镜外科中心,518036

出　　处：《岭南现代临床外科》2009年第1期19-20,29,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨腹腔镜手术与开腹手术治疗胆总管结石的临床效果。方法2001年～2008年对176例患者行腹腔镜胆总管切开探查取石术(1aparoscopiccommonbileductexploration,LCBDE),与同期192例开腹胆囊切除胆总管切开取石、T管引流术(OpencholedocholithotomyT-tubedrainageOCHTD)。两组患者的临床资料进行比较分析。结果两组手术病人均治愈出院。在手术时间,住院费用,术后胆瘘,腹腔脓肿及结石清除率,两组无明显差异(P>0.05)。然而,在术中出血量,术后腹痛次数,胃肠道功能恢复时间,术后伤口感染以及术后肠梗阻,LCBDE组明显优于OCHTD组(P<0.05)。结论LCBDE术式微创,临床效果好,能取代大部分开腹胆总管探查术。Objective To compare the clinical results of choledocholithotomy by laparoscopic surgery and open surgery. Methods 176 patients with choledocholithiasis underwent laparoscopic common bile duct exploration and at the same time, 192 patients received open choledocholithotomy T- tube drainage were compared. The clinical data in the two groups were analyzed comparatively. Results The patiemts of two groups were cured to discharge from hospital. In the operative time, hospitalization cost, postoperative biliary leakage, abdominal abscess and calculous clearance rate, there was no significant difference （P〉0.05）. However, in the volume of intraoperative bleeding, postoperative pain, time of gastrointestinal recovery, hospitalization time postoperative wound dehiscence and infection and postoperative intestinal obstruction, the LCBDE group was much superior to the OCHTD group（P〈0.01 ）. Conclusions LCBDE is minimally invasive surgery. It has good clinical results. In most of cases, it can replace open choledocholithotomy.

关 键 词：腹腔镜 胆总管结石 胆总管切开取石术 

分 类 号：R657.4[医药卫生—外科学]