腹腔镜联合十二指肠镜治疗胆囊结石并肝外胆管结石临床效果及安全性分析  

Clinical effects and safety of laparoscopy combined with duodenal endoscopy in treatment of cholecystolithiasis and extrahepatic bile duct cholelithiasis

作　　者：汪旭[1] 俞小炯[1] 

机构地区：[1]四川省人民医院肝胆外二科,成都610072

出　　处：《安徽医学》2015年第3期318-321,共4页Anhui Medical Journal

摘　　要：目的探讨腹腔镜联合十二指肠镜(LC+EST)治疗胆囊结石并肝外胆管结石的临床效果,并与传统开腹胆囊切除+胆管切开取石+T管引流术(OC+OCH+TD)进行比较,分析其可行性、安全性和经济性。方法收集2010年1月至2014年3月四川省人民医院收治的胆囊结石并肝外胆管结石患者80例,随机分为两组。研究组40例患者行LC+EST治疗,对照组40例患者行传统OC+OCH+TD治疗,观察两组手术成功率及并发症情况,记录两组手术时间、术后进食时间、胃肠功能恢复时间、住院时间等,统计分析两组住院费用。结果两组手术成功率、并发症发生率差异均无统计学意义(P>0.05);研究组手术时间明显长于对照组(P<0.05),但术后进食时间、胃肠功能恢复时间、住院时间明显短于对照组(P<0.05);两组患者总住院费用差异无统计学意义(P>0.05)。结论 LC+EST治疗胆囊结石并肝外胆管结石效果较好,能够有效缩短患者恢复时间,安全性与经济性较好,值得推广。Objective To investigate the clinical effect of laparoscopic cholecystectomy combined with endoscopic sphincterotomy( LC + EST) in the treatment of cholecystolithiasis and extrahepatic bile duct cholelithiasis,compared with traditional open cholecystectomy +open choledocholithotomy + T-tube drainage( OC + OCH + TD),to analyze the feasibility,safety and economy of LC + EST. Methods The clinical data of patients with cholecystolithiasis and extrahepatic bile duct cholelithiasis from January 2010 to March 2014 in our hospital were selected,of which 40 patients treated with LC + EST were selected as research group,and 40 patients treated with OC + OCH + TD were selected as control group; the success rate and complications were observed,operative time,postoperative feeding time,recovery time of gastrointestinal function,hospitalization time of the two groups were recorded,and hospitalization costs of two groups were analyzed. Results The difference was not statistically significant in the surgical success rate and complication rate of two groups compared( P > 0. 05); operative time of research group was significantly longer than that of the control group( P < 0. 05),but postoperative feeding time,gastrointestinal function recovery time and length of hospital stay time were significantly shorter than those of the control group( P < 0. 05); the difference was not statistically significant in the total hospital cost of the two groups( P > 0. 05). Conclusion The clinical effect of LC + EST in the treatment of cholecystolithiasis and extrahepatic bile duct cholelithiasis is good,compared with traditional operation. LC + EST can effectively shorten the recovery time of patients,and it does not increase the complications incidence and treatment costs; thus the safety and economy is good,and it is worth clinical promotion.

关 键 词：腹腔镜 十二指肠镜 胆囊结石 肝外胆管结石 

分 类 号：R657.4[医药卫生—外科学]