腹腔镜联合胆道镜微创保胆取石治疗胆囊结石的临床效果分析  

Clinical effect of laparoscopic combined choledoscopic cholecysto-lithotomy for the treatment of gallstone

作　　者：马吉安[1] 刘维政[1] 潘毅[1] 

机构地区：[1]四川省达州市中西医结合医院肝胆外科,635000

出　　处：《中华普外科手术学杂志（电子版）》2017年第4期316-318,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨腹腔镜联合胆道镜微创保胆取石治疗胆囊结石的临床效果。方法回顾性分析2014年5月至2015年10月肝胆外科收治的170例胆囊结石患者临床资料,按手术方式分为腹腔镜联合胆道镜保胆取石术组(LCCC组)72例与腹腔镜胆囊切除术组(LC组)98例,分析比较两组患者的手术情况、术后并发症情况及术后1年内随访情况。应用SPSS 23.0软件进行统计分析。患者年龄、病程、术中术后各项指标及术后1年生存质量评分等计量资料以均数±标准差(x珋±s)表示,比较采用独立样本t检验;患者性别比、结石单发多发情况、临床症状有情况、术后并发症情况等计数资料比较采用四格表χ2检验,P<0.05为差异有统计学意义。结果 LCCC组的手术时间明显长于LC组(P<0.05),LCCC组的术中出血和进食恢复时间明显低于LC组的(P<0.05)。两组患者反流性食管炎、反流性胃炎、术后腹泻的发生率差异无统计学意义(P>0.05);LCCC组的结石复发率明显高于LC组(P<0.05)。LCCC组术后1年的主观症状评分和GLQI总分明显高于LC组患者(P<0.05)。结论 LCCC术能明显减少术中出血量和进食恢复时间,改善患者预后生活质量,值得临床推广应用。Objective To investigate the clinical effect of laparoscopic combined choledoscopic cholecysto-lithotomy for the treatment of gallstone. Methods Clinical data of 170 patients with gallstones in our hospital from May 2014 to October 2015 were selected and divided into LCCC group（72 cases） and LC group（98 cases）. The situation of operation and postoperative complication were compared and 1 year postoperative was followed-up. Statistical analysis was performed by using SPSS 23. 0. The measurement data such as age,course of diseases,Intraoperative and postoperative indexes,1 year of postoperative survival quality score were presented as（x珋± s）,and the difference was compared with the independent t test between the two groups. The numeration data such as sex ratio,calculi situation,clinical symptom and postoperative complications were presented as percentage,and the difference was compared with four-table chi-square test between the two groups. P value of 0. 05 was considered as significant difference. Results The operation time of LCCC group was significantly longer than that in the LC group（P 〈0. 05）; The blood loss during operation and eating recovery time was significantly lower（P 〈0. 05）. There was no significant difference in the incidence rate of reflux esophagitis,reflux gastritis and postoperative diarrhea between the two groups（P 〈0. 05）,and the calculus recurrence rate of LCCC group was higher than that in the LC group（P 〈0. 05）. The subjective symptom scores and GLQI index of 1 year postoperative follow-up of LCCC group was significantly higher than those in the LC group（P 〈0. 05）. Conclusion The LCCC technique can obviously decrease blood loss during operation and the eating recovery time,improve the prognosis of patients quality of life,and it＇s worthy of being widely applied in clinic.

关 键 词：胆结石 胆囊切除术 腹腔镜检查 

分 类 号：R657.42[医药卫生—外科学]