腹腔镜联合胆道镜行保胆取石的临床效果分析  

Clinical Analysis of Laparoscope Combined with Choledochoscope for Preserving Gallbladder and Removing Calculus

作　　者：陈永胜[1] 熊聪[1] 陆惠波 段建文[1] 周丹[1] 刘云鹏[1] 

机构地区：[1]浙江衢化医院,浙江省衢州市324002

出　　处：《中国全科医学》2017年第A01期153-155,共3页Chinese General Practice

摘　　要：目的研究胆囊结石、息肉行腹腔镜联合胆道镜保胆取石治疗的临床效果。方法将2013年5月—2015年4月浙江衢化医院诊疗的胆囊结石、息肉498例患者分为对照组和研究组各249例,对照组采取腹腔镜胆囊切除术治疗,研究组采取腹腔镜联合胆道镜手术保胆取石治疗。对比两组手术时间、术中出血量、排气时间、下床活动时间、住院时间、并发症和分析研究组随访2年内的复发率。结果研究组的手术时间、术中出血量、排气时间、下床活动时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。研究组总并发症率低于对照组,差异有统计学意义(P<0.05)。在2年的随访内,研究组19例失访,复发率3.0%。结论胆囊结石合并息肉进行腹腔镜联合胆道镜治疗,在取出结石、切除息肉的同时保留胆囊功能,创伤小、安全性高,且并发症相对于传统手术少,复发率低,是临床治疗胆囊结石、息肉的首选方式,疗效确切。Objective To study clinical efficacy of laparoscope combined with choledochoscope in preserving gallbladder and removing calculus for gallstone and polyp. Methods 498 cases of patients with gallstone and polyp were divided into the control group and the study group in Zhejiang Quhua Hospital from May 2013 to April 2015 with 249 cases in each group,the control group adopted laparoscopic cholecystectomy,the study group used laparoscope combined with choledochoscope for preserving gallbladder and removing calculus. Two groups were compared for operative time,intraoperative bleeding volume,evacuation time,time of ambulation,hospital stay time and complications,and recurrence rate of the study group within 2-year follow-up was analyzed. Results Operative time, intraoperative bleeding volume, evacuation time, ambulation time and length of stay of the study group were obviously higher than those of the control group, with difference having statistical significance( P < 0. 05). As for complication rate,that of the study group was obviously lower than that of the control group,with difference having statistical significance( P < 0. 05). Within 2-year follow-up,there were 19 cases of patients in the study group absent to follow-up with recurrence rate of 3. 0%. Conclusion Treating gallstone and polyp with laparoscope and choledochoscope can remain gallbladder function when taking out calculus and resecting polyp. It is safer and causes less trauma with less complications compared with traditional operations. Therefore,it is the first choice of treating gallstone and polyp in clinic therapy with obvious curative effect.

关 键 词：胆囊结石病 息肉 腹腔镜检查 胆道镜 

分 类 号：R575.621[医药卫生—消化系统]