腹腔镜联合胆道镜保胆取石手术治疗合并肝硬化胆囊结石的疗效观察  

Effect of preservation of gallbladder and removal of calculus by laparoscopy combined with choledochoscopy on cirrhosis cholecystolithiasis

作　　者：高金亭[1] 缪丁丁[1] 程新生[1] 王甫誉[1] 郑永彬[1] 索质君[1] 黄诗栋[1] 林树俊[1] 

机构地区：[1]广东医学院附属深圳南山医院肝胆外科,广东深圳518052

出　　处：《中国内镜杂志》2014年第7期741-744,共4页China Journal of Endoscopy

摘　　要：目的探讨腹腔镜联合胆道镜保胆取石手术治疗合并肝硬化的胆囊结石患者的可行性与疗效。方法回顾性分析2005年1月～2012年12月该院采用腹腔镜联合胆道镜保胆取石手术治疗的38例肝硬化胆囊结石患者为观察组,同期进行腹腔镜胆囊切除术的38例肝硬化胆囊结石患者为对照组,比较两组间手术中及手术后各项指标,并进行统计学分析。结果观察组的术中出血量和平均住院日均低于对照组,手术前后凝血功能及肝功能的变化明显小于对照组,差异有显著性（P〈0.05）;而对照组术后出血及术后腹泻的发生率明显高于观察组,差异有显著性（P〈0.05）;手术时间、住院费用及术后胆漏及术后切口感染发生率两组差异无显著性（P〉0.05）。结论对符合条件的合并肝硬化的胆囊结石患者实施腹腔镜联合胆道镜保胆取石术具有安全性高、创伤小及康复快的优点,具有满意的疗效。【Objective】To investigate the feasibility and efficacy of preservation of gallbladder and removal of calculus by laparoscopy combined with choledochoscopy on cirrhosis cholecystolithiasis. 【Methods】Retrospective analysis from January 2005 to December 2012, 76 patients with cholelithiasis and liver cirrhosis was carried out,the patients were divided into the observation group and the control group with 38 cases in each group. The observation group were treated with preservation of gallbladder and removal of calculus by laparoscopy combined with choledochoscopy, while the control group were treated with laparoscopic operation. The surgery and post-operative indicators were compared between the two groups. 【Results】In observation group, blood loss, hospitalization time,were less than those in the control group. Before and after surgery, coagulation, liver function changed significantly less than the control group, the difference was statistically significant（P 0.05）; while the control group postoperative bleeding, surgery after the incidence of diarrhea was significantly higher, the difference was statistically significant（P〈0.05）; operative time, hospital costs, and bile leakage, postoperative infection in two groups were no significant difference（P 0.05）. 【Conclusion】Preservation of gallbladder and removal of calculus by laparoscopy combined with choledochoscopy on cirrhosis cholecystolithiasis is a safe, minimally invasive, quick recovery with satisfactory results.

关 键 词：胆囊结石 肝硬化 腹腔镜 胆道镜 保胆取石术 

分 类 号：R657.31[医药卫生—外科学]