腹腔镜联合胆道镜与传统开腹手术治疗胆总管结石的临床疗效对比  

Clinical effects of laparoscopy combined with choledochoscopy vs open surgery for common bile duct stones

作　　者：程利民[1] 刘洋[1] 孙志德[1] 刘淑敏[1] 张学军[1] 

机构地区：[1]承德医学院附属医院肝胆外科,河北省承德市067000

出　　处：《世界华人消化杂志》2014年第36期5699-5702,共4页World Chinese Journal of Digestology

摘　　要：目的:比较腹腔镜联合胆道镜与传统开腹手术治疗胆总管结石的临床疗效.方法:按照手术方案不同将承德医学院附属医院收治的96例胆总管结石患者分为实验组51例和对照组45例,实验组患者给予腹腔镜联合胆道镜手术治疗,对照组患者给予常规开腹手术治疗,比较两组患者手术情况、术后恢复情况及术后并发症发生情况.结果:实验组患者平均手术时间显著长于对照组(126.33 min±18.42 min vs 91.44 min±13.08 min),术中平均出血量显著少于对照组(45.85 m L±10.66 m L vs 110.22 m L±44.59m L),差异具有统计学意义(P<0.05);实验组患者术后镇痛次数、肛门排气时间及住院时间均显著低于对照组(1.28次±0.46次vs 1.68次±0.72次、29.88 h±5.71 h vs 40.06 h±11.05 h、6.58 d±1.16 d vs 9.07 d±1.33 d),差异具有统计学意义(P<0.05);实验组患者术后疼痛和切口感染发生率均显著低于对照组(17.65%vs84.44%、0.00%vs 13.33%),差异具有统计学意义(P<0.05).结论:腹腔镜联合胆道镜手术创伤小、术后恢复时间短、并发症少、治疗费用低,较传统开腹手术更具临床优势,可作为治疗胆总管结石的优选方案.AIM： To compare the clinical effects of laparoscopy combined with choledochoscopy vs open surgery for common bile duct stones. METHODS： Ninety-six patients with common bile duct stones were divided into either an experiment group （n = 51） or a control group （n = 45）. The experiment group was treated by laparoscopy combined with choledochoscopy, and the control group received open surgery. The operative parameters, postoperative recovery, and complications were compared for the two groups. RESULTS： Mean operative time for the experiment group was significantly longer than that for the control group （126.33 min ± 18.42 min vs 91.44 min ± 13.08 min, P 〈 0.05）. Mean bleeding volume for the experiment group was significantly less than that for the control group （45.85 mL ± 10.66 mL vs 110.22 mL ± 44.59 mL, P 〈 0.05）. The number of times of analgesia usage, time to anal exhaust, and length of stay for the experiment group were significantly lower than those for the control group （1.28 ± 0.46 vs 1.68 ± 0.72, 29.88 h ± 5.71 h vs 40.06 h ± 11.05 h, 7.58 d ± 1.16 d vs 11.07 d ± 1.33 d, P 〈 0.05）. The rates of postoperative pain and incision infection for the experiment group were significantly lower than those for the control group （17.65% vs 84.44%, 0.00% vs 13.33%, P 〈 0.05）. CONCLUSION： Laparoscopy combined with choledochoscopy has less surgical trauma, shorter postoperative recovery time, and fewer complications in patients with common bile duct stones.

关 键 词：腹腔镜 胆道镜 开腹手术 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]