双镜联合治疗胆总管结石的临床应用  

Clinical application of laparoscope combined with choled ochoscope in the treatment of common bile duct stone

作　　者：肖家全[1] 张勇[1] 

机构地区：[1]马鞍山市人民医院普外二科,243000

出　　处：《中国临床实用医学》2016年第6期37-40,共4页China Clinical Practical Medicine

摘　　要：目的：对比分析腹腔镜联合胆道镜治疗胆总管结石与传统开腹治疗胆总管结石的临床应用价值。方法回顾性分析2014年9月至2016年9月马鞍山市人民医院收治的102例胆总管结石患者的病例资料，其中50例患者行腹腔镜胆囊切除＋胆总管切开取石＋胆道镜胆总管探查（LCBDE）术，52例患者行传统开腹胆总管切开取石＋胆总管T管引流术，按手术方法不同分为试验组与对照组。试验组行腹腔镜胆囊切除＋胆总管切开取石＋胆道镜胆总管探查（LCBDE）术，胆总管一期缝合或行T管引流；对照组行传统开腹胆总管切开取石＋胆总管T管引流术。对比分析两组的手术时间、术中出血量、术后住院时间、胃肠功能恢复时间、切口感染发生率、结石复发率等，两组均随访半年时间。结果两组患者均顺利完成手术，试验组患者手术时间、术后住院时间、胃肠功能恢复时间、切口感染发生率、结石复发率均少于对照组，组间差异有统计学意义（P〈0.05）；试验组与对照组的结石复发率无明显差异，组间差异无统计学意义（P〉0.05）。结论对于慢性胆囊炎、胆囊结石合并胆总管结石患者，腹腔镜胆囊切除＋胆总管切开取石＋胆道镜胆总管探查（LCBDE）术，具有手术时间短、创伤小、恢复快、并发症少等优势，具有很好的临床应用价值。ObjectiveClinical effect of laparoscope combined with choledochoscope in the treatment of common bile duct stones.Methods50 cases of laparoscopic common bile duct exploration （LCBDE） who were admitted to Ma＆#39;anshan People＆#39;s Hospital from September 2014 to September 2016, and 52 cases of open choledocho1ithotomy T-tube drainage （OCHTD） in the same period were collected. They were divided into experimental group and control group. Analyze time of operation, the intraoperative blood loss, recovery time of gastrointestinal functions, postoperative hospitalization stay, rate of infection of incisional wound, stone recurrence between two groups. Two groups were followed up for half a year.Results Two groups of patients were complete the opertation. In the LCBDE group, time of operation, the intraoperative blood loss, recovery time of gastrointestinal functions, postoperative hospitalization stay, rate of infection of incisional wound were less than OCHTD group, the difference was statistically significant （P〈0.05）. The difference of stone recurrence was not statistically significant （P〉0.05）.Conclusion LCBDE is with lower operative damage, less complications, shorter hospital stay, the gallstones, common bile duct stones can be solved by one surgical treatment. Patients recovered quickly, the results are satisfactory. It is with a broad application prospects, promising well as a treatment of choice for the gallstones with choledocholithiasis.

关 键 词：腹腔镜 胆道镜 胆总管结石 

分 类 号：R657[医药卫生—外科学]