腹腔镜下经胆囊管胆总管探查取石术的疗效分析  

Curative Effects of Laparoscopic Transcystic Common Bile Duct Exploration

作　　者：周永平[1] 郭子健[2] 戴途[1] 陈波[1] 

机构地区：[1]南京医科大学附属无锡第二人民医院肝胆外科,江苏无锡214000 [2]苏州大学附属无锡第四人民医院肝胆外科,江苏无锡214000

出　　处：《中国临床医学》2013年第3期294-296,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:比较腹腔镜下经胆囊管胆总管探查取石术和腹腔镜下胆道探查T管引流术治疗胆囊结石合并胆总管结石的疗效。方法:将2010年6月—2012年6月因胆囊结石合并胆总管结石行手术治疗的89例患者按照手术方法分为观察组(n=45)和对照组(n=44),观察组行腹腔镜下经胆囊管胆总管探查取石术,对照组行腹腔镜下胆道探查T管引流术,对比分析两组的治疗效果、术后并发症发生情况。结果:观察组的手术时间、腹腔引流时间、住院时间和住院费用为(107.1±20.5)min、(1.0±0.6)d、(4.0±1.5)d和(9932±862)元,均明显少于对照组[(149.6±30.2)min、(3.1±0.8)d、(5.8±2.2)d及(12 879±702)元],差异均有统计学意义(P<0.05)。观察组胰腺炎、急性胆汁性腹膜炎、T管引流不畅或胆漏、胆总管结石残留等并发症的总发生率[2.2%(1/45)]低于对照组[11.4%(5/44)],差异有统计学意义(P<0.05)。结论:腹腔镜下经胆囊管胆总管探查取石术具有安全有效、创伤小、恢复快、并发症少等优点。但腹腔镜下经胆囊管胆总管探查取石术有一定的适用范围,要根据患者具体情况选择适宜的术式。Objective：To compare the curative effects of laparoscopic transcystic common bile duct exploration and laparoscopic common bile duct exploration with T-tube drainage in the treatment of cholecystolithiasis associated with common bile duct stones.Methods：From Jun 2010 to Jun 2012,89 patients with cholecystolithiasis associated with common bile duct stones undergoing operation were selected as the objects of the research.According to the selected method of operation,all the patients were divided into the observation group（n=45）who undergoing laparoscopic transcystic common bile duct exploration and the control group（n=44） who undergoing laparoscopic common bile duct exploration with T-tube drainage.The therapeutic effect and complications after operation were compared and analyzed between the two groups.Results： The operation time,peritoneal drainage time,hospitalization time and hospitalization cost in the observation group were（107.1±20.5）min,（1.0±0.6）d,（4.0±1.5）d and（9 932±862） yuan,respectively,which were significantly lower than those in the control group（149.6±30.2）min,（3.1±0.8）d,（5.8±2.2）d and（12 879±702）yuan（P0.05）.In observation group,overall incidence of pancreatitis,acute peritonitis,inadequate T tube drainage or bile duct leakage and residue bile duct stones was 2.2 %（1/45）,which was lower than that in the control group11.4 %（5/44）.The difference was statistically significant（P0.05）.Conclusions： Laparoscopic transcystic common bile duct exploration is safe,effective less invasive and quick recovery.However,laparoscopic transcystic common bile duct exploration should be chose according to the specific situation of patients in clinical practice.

关 键 词：腹腔镜 胆总管探查取石术 胆囊结石 胆总管结石 疗效 

分 类 号：R657.42[医药卫生—外科学]