腹腔镜胆囊切除术与保胆取石术治疗胆囊结石对比分析  

The comparative analysis of two treatments for cholecystolithiasis:laparoscopic gallbladder-preserving lithotomy and laparoscopic cholecystolithotomy

作　　者：骆助林[1] 田伏洲[1] 陈理国[2] 王瑞丰[1] 陈龙[1] 黄竹[1] 宋宗涛[2] 

机构地区：[1]成都军区总医院全军普通外科中心,四川成都610083 [2]解放军第452医院普通外科,四川成都610021

出　　处：《局解手术学杂志》2012年第6期639-641,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：四川省卫生厅科研基金(编号:110491)

摘　　要：目的比较腹腔镜胆囊切除术和腹腔镜下联合胆道镜保胆取石术治疗胆囊结石的疗效。方法回顾分析我院2004年1月至2010年1月收治胆囊结石患者的临床资料,其中行经腹腔镜下切开胆囊底部应用纤维胆道镜保胆取石80例,同期选取病情情况相似的患者行腹腔镜胆囊切除术80例。观察两组手术时间、术中出血量、术后住院天数及术后饮食恢复时间;保胆取石组患者术后第2年复查胆囊收缩功能和胆囊壁厚度,统计胆囊结石复发率。结果保胆取石组在手术时间、术后住院天数、住院费用上与胆囊切除组无统计学差异(P>0.05);术中出血量、术后饮食恢复时间,保胆取石组明显优于胆囊切除组(P<0.05),术后第2年复查胆囊收缩功能较术前明显改善(P<0.05),术后随访2～8年胆结石复发5例。结论经腹腔镜联合胆道镜保胆取石术结石复发率低,相比腹腔镜胆囊切除术更加安全、创伤小且恢复快,具有临床推广价值。Objective To compare and analyze laparoscopic cholecystectomy and laparoscopic gallbladder-preserving lithotomy com- bined with choledochoscopy surgical treatment for cholecystulithiasis. Methods Collect the cholecystolithiasis data of patients in our hospital from January 2004 to January 2010, there were 80 patients who met the demand of lithotomy in protecting gallbladder and were taken by lapa- roscopic gallbladder-preserving lithotomy combined with choledochoscopy for cholecystolithiasis. At the same time, select 80 cases who has the similar general situation to be treated by laparoscopic cholecystectomy. Observe the operative time, perioperative bleeding and postopera- tive days and postoperative diet recovery time. 2 years after cholecystolithotomy, the patients were reviewed the gallbladder systolic function and the gallbladder wall thickness, statistical the recurrence rate of gallbladder stone. Results There are no statistical difference （ P 〉 0.05 ） between the two groups in the operating time, postoperative days and hospital charge. In perioperative bleeding and postoperative diet recovery time, cholecystolithotomy group is obviously superior to laparoscopic eholecystectomy group（ P 〈 0.05 ）. The gallbladder systol- ic function obviously improved after two years （ P 〈 0.05 ）, 2 - 8 years of follow-up show that gallstone recurrence in 5 patients. Conclusion Laparoscopie gallbladder-preserving lithotomy combined with choledochoscopy was security, small trauma, less pain, rapid recovery and low recurrence rate, and have clinical application value.

关 键 词：保胆取石术 腹腔镜胆囊切除术 胆道镜 胆囊结石 

分 类 号：R657.42[医药卫生—外科学]