腹腔镜联合胆道镜治疗老年胆囊结石合并胆总管结石的临床分析  

Clinical analysis in treatment of senile patients with cholecystolithiasis and choledocholithiasis by laparoscopy combined with choledochoscopy

作　　者：张重捷 邹奇[1] 陈杰[1] 王勇[1] 李春生[1] ZHANG Chong-jie ZHOU Qi CHEN Jie WANG Yong LI Chun-sheng.(Departments of Hepatobiliary Surgery, Shanghai Pudong Hospital Affiliated Fudan University, Shanghai 201399, China)

机构地区：[1]复旦大学附属上海市浦东医院肝胆外科,上海市201399

出　　处：《实用老年医学》2017年第1期69-72,共4页Practical Geriatrics

摘　　要：目的探讨腹腔镜联合胆道镜行胆囊切除胆总管切开取石术治疗老年胆囊结石合并胆总管结石病人的安全性和可行性。方法选取我院2012年6月至2014年6月>70岁老年胆囊结石合并胆总管结石病人24例作为观察组,行腹腔镜胆囊切除胆总管切开取石术。收集同期开腹胆囊切除、胆总管切开取石病人26例作为对照组。分析比较2组病人的临床疗效。结果 2组病人的手术成功率、手术时间比较,差异无统计学意义(P>0.05);观察组较对照组术中出血量少,术后疼痛程度轻,术后通气时间及住院时间明显缩短,2组比较差异均有统计学意义(P<0.05)。结论腹腔镜联合胆道镜治疗老年胆囊结石合并胆总管结石可明显减轻术后疼痛程度,缩短住院时间,是一种安全有效的微创治疗方法。Objective To discuss the safety and feasibility of laparoscopic cholecystectomy（LC）combined with laparoscopic common bile duct exploration（LCBDE） in treatment for concomitant cholecystolithiasis and choledocholithiasis in elderly patients.Methods Twenty-four cases with cholelithiasis and choledocholithiasis over age of 70 years in our hospital from June 2012 to June 2014 were chosen as observation group who underwent LC and LCBDE.Twenty-six cases with cholelithiasis and choledocholithiasis who performed open cholecystectomy（OC） and common bile duct exploration（CBDE） were collected as the control group in the same period.Clinical effects were analysed and compared between the two groups.Results There were no statistical significances in the success rate of operation and procedure time between two groups（P〉0.05）.Compared to control group,the amount of bleeding of patients was less,the incidence of postoperative complications and postoperative pain degrees was lower,the postoperative exhaust time and hospital stay were shorter in observation group（P〈0.05）.Conclusions Laparoscopic combined with choledochoscope is a safe and effective minimally invasive treatment,which can obviously shorten the hospital stay,and reduce the degree of pain.

关 键 词：胆囊结石 胆总管结石 腹腔镜 胆道镜 老年人 

分 类 号：R657.42[医药卫生—外科学]