两种腹腔镜胆总管探查取石术式治疗胆总管结石的临床对比研究  

Clinical comparative study of two kinds of laparoscopic common bile duct exploration and lithotomy in the treatment of choledocholithiasis

作　　者：郭忠涛[1] 高德山[1] 王仁启[1] 李永[1] 晁宏伟[1] GUO Zhong-tao;GAO De-shah;WANG Ren-qi(Department of General Surgery, People＇ s Hospital of Puyang City, Puyang 457000, Chin)

机构地区：[1]濮阳市人民医院,河南濮阳457000

出　　处：《腹腔镜外科杂志》2018年第3期194-197,共4页Journal of Laparoscopic Surgery

摘　　要：目的:探讨腹腔镜经胆囊管胆总管探查取石术(laparoscopic transcystic common bile duct exploration,LTCBDE)、腹腔镜胆总管探查取石一期缝合术(laparoscopic common bile duct exploration and primary suture,LBEPS)治疗胆总管结石的临床疗效及安全性。方法:选取2014年4月至2016年4月收治的100例胆总管结石患者,根据手术方案分为A组(n=50,行LBEPS)与B组(n=50,行LTCBDE);比较两组手术相关临床指标、结石残余率、结石复发率及术后并发症发生率。结果:B组术后24 h引流量、引流管拔除时间、住院时间、胆漏发生率均少于A组(P<0.05);两组手术时间、术中出血量、首次肛门排气时间、结石残余率、结石复发率及切口感染、胆道狭窄、再发黄疸发生率差异无统计学意义(P>0.05)。结论:相较LBEPS,LTCBDE治疗胆总管结石可有效减少引流量,缩短引流时间、总住院时间,有助于减少胆漏的发生。Objective： To investigate the clinical effects and safety of laparoscopic transcystic common bile duct exploration（ LTCBDE） and laparoscopic common bile duct exploration and primary suture（ LBEPS） in the treatment of choledocholithiasis. Methods： From Apr. 2014 to Apr. 2016,100 patients with choledocholithiasis were chosen and divided into two groups： group A（ n = 50）with LBEPS and group B（ n = 50） with LTCBDE; and the operation related clinical indicators,the calculi residual rate,the calculi recurrence rate and the postoperative complications incidence of both groups were compared. Results： The drainage volume in 24 h after operation,the drainage time,hospital stay and bile leakage incidence of group B were significantly lower than those of group A（ P 〈0. 05）. There was no significant difference in the operation time,the amount of bleeding in operation,the first anal exhaust time,the calculi residual rate,the calculi recurrence rate,the incidence of incision infection,biliary stricture or recurrent jaundice between the two groups（ P 〉0. 05）. Conclusions： Compared with LBEPS,LTCBDE operation in treatment of choledocholithiasis can efficiently reduce the drainage volume,shorten the drainage time and the total hospitalization time and be helpful in avoiding bile leakage.

关 键 词：胆总管结石 腹腔镜检查 经胆囊管胆总管探查取石术 胆总管探查取石一期缝合术 对比研究 

分 类 号：R657.4[医药卫生—外科学]