腹腔镜联合胆道镜钬激光治疗胆总管结石的临床应用  

Study on clinical application of laparoscopy combined with holmium laser for the treatment of choledocholithiasis

作　　者：姚宗浠[1] 居建祥 刘玉林 Yao Zongxi;Ju Jianxiang;Liu Yulin(Suzhou Wuzhong People's Hospital, Jiangsu Suzhou 215128, China)

机构地区：[1]苏州市吴中人民医院

出　　处：《腹部外科》2019年第4期280-283,290,共5页Journal of Abdominal Surgery

摘　　要：目的探讨腹腔镜下钬激光碎石治疗胆总管结石的疗效及临床应用价值。方法回顾性分析2016年1月至2017年12月苏州市吴中人民医院收治的83例胆总管结石手术病例,行腹腔镜常规胆总管控查术(对照组)60例,腹腔镜联合钬激光碎石术(钬激光组)23例,分别对两组中的术前基本资料、手术时间、取石时间、术中出血量、T管放置情况、术后排气时间、术后引流管放置时间、术后疼痛评分、术后胆漏发生率、术后残余结石发生率、术后住院天数、住院费用情况等进行统计学分析。结果两组在术前各项基本资料、术中出血量、术后排气时间、术后引流管放置时间比较,差异无统计学意义(P>0.05)。两组在手术时间、取石时间、T管放置率、术后疼痛评分(M)、术后住院天数、住院费用、术后胆漏发生率、术后残余结石发生率比较,差异均有统计学意义(P<0.05)。结论腹腔镜下联合钬激光治疗胆总管结石是安全可行的,其具有手术时间短、取石时间短、T管放置率降低、术后疼痛轻、术后住院时间短、住院费用低等优势;对今后更好开展此类手术提供了重要的依据。Objective To investigate the effects and application values of laparoscopy combined with holmium laser in the treatment of choledocholithiasis. Methods 83 cases of choledocholithiasis treated in Wuzhong People's Hospital of Suzhou from January 2016 to December 2017 were analyzed retrospectively (60 cases in control group and 23 cases in holmium laser group). The preoperative basic data, operation time, stone removal time, intraoperative blood loss, T tube placement, postoperative exhaust time, postoperative drainage tube placement time, postoperative pain score, incidence of postoperative bile leakage, incidence of postoperative residual stones, postoperative hospital stay and hospitalization costs were statistically analyzed. Results T here was no significant difference between the two groups in preoperative basic data, intraoperative blood loss, postoperative exhaust time and postoperative drainage tube placement time ( P >0.05). The differences in the operation time, stone removal time, T-tube placement rate, postoperative pain score (M), postoperative hospital stay, hospitalization cost, incidence of postoperative bile leakage and incidence of postoperative residual stones between the two groups had statistical significance ( P <0.05). Conclusion Laparoscopy combined with holmium laser for the treatment of choledocholithiasis is safe and feasible. Laparoscopy combined with holmium laser for the treatment of choledocholithiasis has advantages of shorter operation time, shorter stone removing time, lower T-tube placement rate, less postoperative pain, shorter postoperative hospitalization time and lower hospitalization cost;it provides an important basis for better carrying out such operations in the future.

关 键 词：钬激光 腹腔镜 胆总管结石 碎石术 

分 类 号：R657.4[医药卫生—外科学]