腹腔镜联合胆道镜治疗胆囊胆总管结石的体会  

Manager Experience of Laparoscope with Choledochoscope in Treatment of Cholecystolithiasis Combined with Choledocholithiasis

作　　者：韩留安[1] 李俊祥[1] 

机构地区：[1]河南省新乡市长垣县河南宏力医院普外科,453400

出　　处：《中华全科医学》2011年第7期1059-1060,共2页Chinese Journal of General Practice

摘　　要：目的探讨腹腔镜联合胆道镜治疗胆囊胆总管结石的治疗方法和效果。方法选择2006年12月-2010年12月宏力医院收治的158例胆囊结石合并胆总管结石患者,其中选择80例胆总管直径1.0 cm以上,无上腹部手术史的患者行腹腔镜胆囊切除+胆总管切开取石"T"管引流术(腹腔镜组),与同期开腹胆囊切除+胆总管切开取石"T"管引流术78例(开腹组)对比分析。结果腹腔镜组:术中出血、胃肠功能恢复时间、住院时间均少于开腹组[(150.4±12.8)ml与(300.5±10.6)ml、(1.6±0.8)d与(3.6±0.7)d、(7.5±1.2)d与(13.2±1.8)d],两组比较差异有统计学意义(P均<0.05),且创伤小、术后疼痛轻。开腹组并发症发生率高于腹腔镜组(9.8%与3.8%,P<0.05),但两组手术时间、住院费用差异无统计学意义(P均>0.05)。结论腹腔镜联合胆道镜治疗胆囊胆总管结石具有创伤小、疼痛轻、恢复快、住院时间短等优点,优于传统开腹术。Objective To investigate the operation and effect of laparoscope with choledochoscope in treatment of cholecystolithiasis combined with choledocholithiasis.Methods The clinical data of 158 cases with cholecystolithiasis and choledocholithiasis in our hospital from December 2006 to 2010 December were analyzed retrospectively.The patients in the laparoscope treatment group（80 cases） with a choledochus that its diameter was more than 1.0 cm and without the history of upper abdomen surgery received laparoscopic cholecystectomy and choledocholithotomy and t-tube drainage;while the patients in the open cholecystectomy treatment group（78 cases） received open cholecystectomy and choledocholithotomy and t-tube drainage.The therapeutic efficacy of both groups was compared.Results In the laparoscope treatment group,the intraoperative bleeding,recovery of gastrointestinal function and length of stay were（150.4＋12.8） ml,（1.6＋0.8） d and（7.5＋1.2） d,respectively,and less than those in the open cholecystectomy treatment group [（300.5＋10.6） ml,（3.6＋0.7） d and（13.2＋1.8） d,respectively]（P0.05）.The wound of patients in the laparoscope treatment group was small,and the postoperative pain was light.The incidence（10.8%） of complications in the laparoscope treatment group was obviously lower than that（3.8%） in the open cholecystectomy treatment group,（P0.05）,but there was no significant difference in the operative time and hospitalization cost between the two groups（P0.05）.Conclusion The laparoscope with choledochoscope,with small trauma,less pains,shorter hospitalization time etc,is superior to the traditional open cholecystectomy treatment.

关 键 词：腹腔镜 胆道镜 胆囊胆总管结石 胆道探查术 

分 类 号：R657.42[医药卫生—外科学]