腹腔镜联合十二指肠镜治疗胆结石合并胆总管结石的临床疗效  

Clinical Efficacy of Laparoscopic Combined with Duodenoscopy in Treatment of Gallstones and Bile Duct Stones

作　　者：王新元[1] 马龙斌[1] 何津[1] 张国顺[2] 杨静[3] 

机构地区：[1]河北省唐山市人民医院肝胆外科,河北唐山063001 [2]河北联合大学附属医院消化科,河北唐山063001 [3]河北省唐山市人民医院功能科,河北唐山063001

出　　处：《现代生物医学进展》2015年第5期909-911,925,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨腹腔镜联合十二指肠镜治疗胆结石合并胆总管结石的临床疗效。方法:收集我院肝胆科2012年6月到2014年3月住院的胆结石合并胆总管结石60例,按照随机数字表法分为试验组和对照组,各30例,试验组给予腹腔镜联合十二指肠镜治疗,对照组给予传统的开腹胆囊切除以及胆总管探查取石,观察对比两组的临床疗效。结果:试验组手术时间、住院时间、术后恢复时间及术中出血量明显的短于或少于对照组,差异均具有统计学意义(均P<0.05),试验组治愈率为96.7%明显的高于对照组的66.7%,差异有统计学意义(P<0.05)。两组主要不良反应有:结石残留、感染、十二指肠穿孔、恶性呕吐及伤口疼痛等,试验组不良反应发生率为16.67%明显的低于对照组总的73.33%,差异有统计学意义(P<0.05)。结论:腹腔镜联合十二指肠镜治疗胆结石合并胆总管结石较传统的开腹手术治疗的效果好、恢复时间短、手术创伤小,且具有一定的安全性,不良反应发生少,值得临床推广使用。Objective： To evaluate clinical efficacy of laparoscopic combined with duodenoscopy in treatment of gallstones and bile duct stones. Methods： 60 cases of patients with gallstones and bile duct stones from June 2012 to March 2014 in department of Hepa- tobiliary Hospital were randomly divided into the experimental group（30 cases） and the control group（30 cases）. The experimental group received laparoscopic joint duodenoscopy treatment. The control group were given conventional open cholecystectomy and common bile duct exploration, clinical efficacy of the two groups was observed and compared. Results： The operative time, length of hospital stay, postoperative recovery time and blood loss were significantly shorter or less than those in the control group, the differences were statisti- cally significant （P〈0.05）, the cure rate of the experimental group was 96.7%, higher than the that of the control group（66.7%）, the differ- ence was statistically significant （P〈0.05）. The main adverse events that occurred in the two groups were residual stones, infection, duo- denal perforation, wound pain, vomiting, and vicious. The total incidence of adverse events of experimental group was 16.67%, signifi- cantlylowerthanthatofthecontrolgroup （73.33%）,thedifferencebetweenthetwogroupswasstatisticallysignificant （P〈0.05）.Conelusion： Laparoscopic combined with duodenoscopy in the treatment of gallstones and bile duct stones presents better clinical efficacy than tradi- tional open surgery, the recovery time is shorter, surgical trauma is less and shows certain safety, less adverse reactions, and is worthy of clinical application.

关 键 词：腹腔镜 十二指肠镜 胆结石 胆总管结石 临床疗效 

分 类 号：R657.4[医药卫生—外科学]