腹腔镜和胆道镜及十二指肠镜联合治疗急性梗阻性化脓性胆管炎的临床研究  

Clinical Research of Combination of Laparoscope, Choledochoscope and Duodenoscope for Acute Obstructive Suppurative Cholangitis

作　　者：黄书明[1] 陈圣开[1] 樊大明[1] 张涛[1] 李剑波[1] 

机构地区：[1]重庆市第三人民医院肝胆外科,重庆400014

出　　处：《现代生物医学进展》2015年第23期4525-4527,4531,共4页Progress in Modern Biomedicine

摘　　要：目的：探讨腹腔镜和胆道镜及十二指肠镜联合治疗急性梗阻性化脓性胆管炎（AOSC）的临床效果。方法：选取2007年3月~2014年3月我院收治的100例AOSC患者,根据手术方法的不同与患者的意愿分为研究组50例与对照组50例,研究组采用腹腔镜和胆道镜及十二指肠镜联合治疗,对照组采用开腹胆囊切除及胆道探查术。观察两组的生化指标、术后并发症、切口感染率、术后残石率。结果：研究组白细胞计数（WBC）、血直接胆红素（DBIL）、丙氨酸转氨酶（ALT）、谷氨酰转肽酶（GT）、天冬氨酸转氨酶（AST）明显低于对照组（P〈0.05）。研究组术后并发症、切口感染明显少于对照组（P〈0.05）。两组术后1年残石比较差异无统计学意义（P〉0.05）。结论：腹腔镜和胆道镜及十二指肠镜联合治疗AOSC患者具有创伤小、愈合恢复快、并发症发生率低、预后好等优点。Objective： To investigate the clinical effect of combination of laparoscope,choledochoscope and duodenoscope in the treatment of acute obstructive suppurative cholangitis（AOSC）. Methods： A total of 100 patients with AOSC, who were admitted to Chongqing Third People＇s Hospital from March 2007 to March 2014, were selected and divided into research group（n=50） and control group（n=50） according to the operation methods and the patients＇ wishes. The research group were given a combination of laparoscopy,choledochoscopy and duodenoscopy, while the control group, open cholecystectomy and common bile duct exploration. The biochemical indexes, postoperative complications,incision infection rates, postoperative residual stone rates of the two groups were observed. Results：The WBC, DBIL, ALT, GT, AST of the research group were significantly lower than those of the control group（P 0.05）. The postoperative complications and incision infection of the research group were significantly less than those of the control group（P〈0.05）.There was no statistical significance in the residual stones 1 year after operation between the two groups（P〉0.05）. Conclusions： The combination of laparoscope,choledochoscope and duodenoscope has the advantages of less trauma, rapid healing, low complication rate,and better prognosis in the treatment of patients with AOSC.

关 键 词：急性梗阻性化脓性胆管炎 腹腔镜 胆道镜 十二指肠镜 

分 类 号：R657.4[医药卫生—外科学]