腹腔镜手术治疗胆囊结石合并胆总管结石的临床疗效  

Clinical effects of laparoscopic surgery in treatment of gallbladder stones with choledocholithiasis

作　　者：程利民[1] 张国志[1] 刘洋[1] 孙志德[1] 张学军[1] 

机构地区：[1]河北联合大学,河北省唐山市063000

出　　处：《世界华人消化杂志》2015年第5期809-812,共4页World Chinese Journal of Digestology

摘　　要：目的:比较腹腔镜手术与传统开腹手术治疗胆囊结石合并胆总管结石的临床效果.方法:按照收治随机数字表法将河北联合大学附属医院收治80例胆囊结石合并胆总管结石患者均分为观察组与对照组,分别给予腹腔镜手术和传统开腹手术治疗,比较两组患者手术一般情况、术后并发症发生情况以及随访期间残石率、胆漏率、复发率.结果:观察组患者手术时间、术中出血量、肛门排气时间、下床活动时间及出院时间均显著少于对照组(60.28 min±11.64 min vs 105.61 min±21.16 min、38.36 m L±8.31m L vs 148.36 m L±16.20 m L、1.76 d±0.82d vs 3.10 d±1.12 d、1.53 d±0.78 d vs 2.52d±1.05 d、6.62 d±2.13 d vs 14.27 d±4.58d),差异具有统计学意义(P<0.05);观察组并发症总发生率显著低于对照组(7.50%vs27.50%),差异具有统计学意义(P<0.05);观察组患者残石率、胆漏率及复发率均显著低于对照组(5.00%vs 20.00%、2.50%vs15.00%、0.00%vs 10.00%),差异具有统计学意义(P<0.05).结论:采用腹腔镜手术治疗胆囊结石合并胆总管结石,创伤小,术后恢复快,能有效降低并发症发生率、残石和胆漏率,并减少术后复发,安全可靠,值得推广.AIM：To evaluate the clinical effects of laparoscopic surgery in the treatment of gallbladder stones with choledocholithiasis.METHODS：Eighty patients with gallbladder stones complicated with choledocholithiasis were randomly divided into either an observation group or a control group.The observation group was treated by laparoscopic surgery,and the control group was treated by conventional surgery.The general status of patients,complications,and the rates of residual stones,bile leak,and relapse were compared for the two groups.RESULTS：The operative time,bleeding volume,time to first anus exhaust,time to ambulation,and hospitalization time for the observation group were significantly better than those for the control group（60.28 min ± 11.64 min vs 105.61 min ± 21.16 min,38.36 mL ± 8.31 mL vs 148.36 mL ± 16.20 mL,1.76 d ± 0.82 d vs 3.10 d ± 1.12 d,1.53 d ± 0.78 d vs 2.52 d ± 1.05 d,6.62 d ± 2.13 d vs 14.27 d ± 4.58 d,P 〈 0.05）.The rate of complications for the observation group was significantly lower than that for the control group（7.50%vs 27.50%,P 〈 0.05）.The rates of residual stones,bile leak,and relapse for the observation group were also significantly lower than those for the control group（5.00%vs 20.00%,2.50%vs 15.00%,0.00%vs 10.00%,P 〈 0.05）.CONCLUSION：Laparoscopic surgery is superior to conventional surgery in the treatment of gallbladder stones with choledocholithiasis with regard to minimal surgical trauma,quicker recovery,and lower rates of complication,residual stones,bile leak,and relapse.

关 键 词：胆总管结石 胆囊结石 腹腔镜手术 开腹手术 

分 类 号：R657.4[医药卫生—外科学]