腹腔镜与开腹治疗胆囊并胆总管结石效果及费用比较  

EFFICACY AND COST OF LAPAROSCOPY VERSUS LAPAROTOMY IN TREATMENT OF GALLSTONES WITH COMMON BILE DUCT STONES

作　　者：徐少新 葛忠[1] 丁明辉[1] 于江 万广绪 信明军 XU Shaoxin;GE Zhong;DING Minghui;YU Jiang;WAN Guangxu;XIN Mingjun(Department of He-patobiliary Surgery,Qingdao Municipal Hospital,The Third Affiliated Hospital of Qingdao University,Qingdao 266011,China)

机构地区：[1]青岛大学附属青岛市市立医院肝胆外科

出　　处：《青岛大学学报（医学版）》2020年第1期76-79,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省医药卫生科技发展计划项目(2014WS0214)

摘　　要：目的回顾性研究胆囊结石合并胆总管结石手术治疗中腹腔镜胆囊切除+胆总管切开取石T管引流与传统开腹手术的临床结果与费用对比情况。方法2015年4月—2018年9月,我院收治胆囊结石合并胆总管结石病人236例,按照手术方式的不同分为两组,对照组为传统开腹手术组,观察组为腹腔镜组。两组病人年龄、性别等一般资料无明显差异。比较两组病人手术时间、术中出血量、总体费用、术后住院时间、总住院时间、术后3 d最高体温、术后疼痛评分等指标。结果与对照组比较,观察组在手术时间、术中出血量、术后住院时间、术后疼痛评分等方面差异均有显著性(t=-69.119~52.938,P<0.05),而在总体费用、术后3 d最高体温和总住院时间等方面差异无显著性(P>0.05)。结论腹腔镜下胆总管切开取石术治疗胆囊结石并胆总管结石具有创伤小、术后康复快、术后住院时间短、术后疼痛轻等优势,而费用方面与传统手术相差不大。Objective To investigate the clinical effect and cost of laparoscopic cholecystectomy+choledocholithotomy and T-tube drainage versus traditional laparotomy in the surgical treatment of gallstones with common bile duct stones.Methods A total of 236 patients with gallstones and common bile duct stones who were admitted to our hospital from April 2015 to September 2018 were enrolled,and according to the surgical approach,they were divided into control group(treated with traditional laparotomy)and observation group(treated with laparoscopy).There were no significant differences in general information,age,and sex between the two groups.The two groups were compared in terms of time of operation,intraoperative blood loss,overall costs,length of postoperative hospital stay,total length of hospital stay,maximum body temperature on day 3 after surgery,and posto-perative pain score.Results There were significant differences between the control group and the observation group in time of operation,intraoperative blood loss,length of postoperative hospital stay,and postoperative pain score(t=-69.119 to 52.938,P<0.05),while there were no significant differences in overall costs,maximum body temperature on day 3 after surgery,and total length of hospital stay between the two groups(P>0.05).Conclusion Compared with traditional laparotomy,laparoscopic common bile duct exploration has the advantages of little trauma,rapid recovery after surgery,short length of postoperative hospital stay,and mild postoperative pain,while there is no significant difference in cost between these two methods.

关 键 词：胆石 腹腔镜检查 胆道外科手术 治疗结果 费用效益分析 

分 类 号：R657.4[医药卫生—外科学]