腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的疗效分析  

Analysis of the efficacy of laparoscopic cholecystectomy on gallbladder stone with common bile duct stones

作　　者：曹辉 高凤勤 

机构地区：[1]淮南市东方集团总医院普外科,淮南232000

出　　处：《肝胆外科杂志》2017年第6期434-436,共3页Journal of Hepatobiliary Surgery

摘　　要：目的分析比较腹腔镜联合胆道镜与开腹手术治疗胆囊结石合并胆总管结石的疗效。方法回顾性分析我院于2013年1月~2017年1月收治的胆囊结石合并胆总管结石患者50例,依据手术方式(腹腔镜联合胆道镜或开腹)的不同,将使用腹腔镜联合胆道镜手术治疗设为实验组(25例),将使用开腹手术治疗设为对照组(25例)。分析比较两组患者的结石取净率、手术时间、住院时间、术中出血量及术后并发症等指标。结果实验组患者术中出血量为(38.3±7.1ml),术后肛门排气恢复时间为(1.7±0.6d),术后住院时间为(5.5±1.3d),均低于对照组的86.3±14.7ml,2.8±0.9d,8.4±1.8d(P均<0.05)。实验组术后切口感染和胆瘘的发生率(均为0.0%)均低于对照组(均为12%)(P<0.05)。实验组患者手术时间(128.3±24.2min)现在高于对照组手术时间(103.7±21.2min)(P<0.05)。实验组和对照组结石取净率均为100%。结论较之传统开腹手术,使用腹腔镜联合胆道镜治疗胆总管结石能显著缩短术后肛门排气时间和住院时间,减少术中出血量和术后并发症,是安全有效的手术方式。Objective To compare the efficacy of laparoscopy combined with choledochoscopy and open surgery in the treat- ment of gallstones with choledocholithiasis. Methods Fifty patients with gallstones combined with choledocholithiasis were enrolled in our hospital from January 2013 to January 2017. According to the different surgical methods used （ laparoscopic cholecystectomy or open surgery）, the patients treated with laparoscopic cholecystectomy were divived into the experimental group （n =25 ）, while those treated with open surgery were divived into the control group （ n = 25 ）. Analysis of the two groups of patients with stone removal rate, operation time, length of stay, intraoperative blood loss and postoperative complications in the two groups were analysed and compared. Results The operative time, the recovery time of anal exhaust and the postoperative hospital stay in the experimental group were 38. 3 ±7. 1ml, 1.7 ±0. 6d and 5.5 ± 1.3d respectively, which were lower than those in the control group 86. 3 ± 14. 7ml, 2. 8±0. 9d and 8.4± 1.8d respectively. Both the rate of postoperative incision infection and biliary fistula in the experimental group （0. 0% ） were lower than those in the control group （ 12% ）. The operative time in the experimental group （ 128. 3 ± 24. 2min） was longer than that inthe control group （ 103.7 ±21.2min） （P 〈0. 05）. The removal rate of stones was 100% in both groups. Conclusion Compared with tra-ditional open surgery, laparoscopic cholecystectomy can significantly shorten the postoperative anal exhaust time and hospitalization time, reduce intraoperative blood loss and postoperative complications, which is a sfe and effective surgical approach.

关 键 词：腹腔镜 胆道镜 开腹手术 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]