腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床应用研究  

Clinical Study of Laparoscope Combined with Choledochoscope in Treatment of Patients with Cholecystolithiasis and Choledocholithiasis

作　　者：赵冬雨[1] 成丽娅[1] 沈宏[1] 张宁[1] 

机构地区：[1]武警后勤学院附属医院普通外科,天津300162

出　　处：《中国普外基础与临床杂志》2013年第7期793-796,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨腹腔镜与胆道镜联合治疗胆囊结石合并胆总管结石的临床效果。方法对笔者所在医院肝胆外科2009年3月至2011年2月期间收治的74例胆囊结石合并胆总管结石患者的临床资料进行回顾性分析,其中行腹腔镜联合胆道镜治疗者37例(简称双镜手术组),行常规开腹手术治疗者37例(简称开腹手术组),比较2组患者的术中情况及其治疗效果和并发症情况。结果 2组患者的结石清除率均为100%;术后2组患者的结石复发率比较差异无统计学意义(P>0.05);双镜手术组的手术时间长于开腹手术组(P<0.01),出血量少于开腹手术组(P<0.01),术后肛门排气时间、术后下床活动时间及总住院时间均短于开腹手术组(P<0.01);术后并发症发生率低于开腹手术组(P<0.01)。结论腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石患者可取得良好效果,具有创伤小、恢复快、并发症少等优点,值得推广。Objective To study the clinical effects of laparoscope combined with choledochoscope in patients with cholecystolithiasis and choledocholithiasis.Methods Clinical data of 74 patients with cholecystolithiasis and choledocholithiasis between Mar.2009 and Feb.2011 in our hospital were retrospectively analyzed.Among them,37 cases underwent the laparoscope combined with choledochoscope operation（referred to as the double mirror operation group）and 37 cases underwent the conventional open operation（open operation group）.The intraoperative conditions,therapeutic effect,and complications of patients in 2 groups were compared.Results The stone clearance rates of the two groups were 100%.The recurrence rate of 2 groups in the follow-up process was no significantly difference（P0.05）.In the double mirror operation group,the operative time was significantly longer than that open operation group（P0.01）;the intraoperative bleeding was significantly less than that open operation group（P0.01）;the anal exhaust time after operation,get out of bed time after operation,and total duration of hospitalization were significantly shorter than that open operation group（P0.01）;and the incidence of postoperative complications was significantly lower than that open operation group（P0.01）.Conclusion Laparoscope combined with choledochoscope in treatment of cholecystolithiasis and choledocholithiasis patients has exact effects,with minor trauma,quicker recovery,and fewer complications,and it’s worthy of promotion.

关 键 词：腹腔镜 胆道镜 胆囊结石 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]