腹腔镜联合胆道镜治疗肝内外胆管结石的疗效及安全性评价  

Evaluation on curative effects and safety of laparoscopy combined with cholangioscopy in treatment of intra and extrahepatobiliary tract stones

作　　者：阳光[1] 宋向晖[1] 施景龙 YANG Guang;SONG Xianghui;SHI Jinglong(Department of General Surgery,the Twelfth People’s Hospital of Guangzhou,Guangdong,Guangzhou 510000,China)

机构地区：[1]广州市第十二人民医院普外科,广东广州510000

出　　处：《中国医药科学》2020年第3期285-287,共3页China Medicine And Pharmacy

摘　　要：目的评价腹腔镜联合胆道镜治疗肝内外胆管结石的疗效及安全性。方法纳入我院2015年12月~2018年12月60例肝内外胆管结石患者进行回顾性分析,根据治疗方式不同分为对照组(实施常规开腹手术)30例、实验组(实施腹腔镜联合胆道镜手术)30例。记录两组患者手术情况(手术耗时、结石取净率、术中出血量),术后恢复情况(术后镇痛时间、胃肠道恢复时间、T管夹闭时间、腹腔管拔除时间)以及并发症发生情况。结果两组患者手术耗时无统计学差异(P>0.05),实验组患者结石取净率明显高于对照组(P<0.05),术中出血量明显小于对照组(P<0.05);实验组患者术后镇痛时间、胃肠道恢复时间、T管夹闭时间、腹腔管拔除时间均明显小于对照组(P均<0.05);实验组患者胆漏、胆道出血、胆道感染等并发症总发生率明显低于对照组(P<0.05)。结论腹腔镜联合胆道镜治疗肝内外胆管结石较传统开腹手术创伤小,结石清除率高,且并发症少。Objective To evaluate curative effects and safety of laparoscopy combined with cholangioscopy in treatment of intra and extrahepatobiliary tract stones.Methods 60 patients withintra and extrahepatobiliary tract stones who were admitted to our hospital from December 2015 to December 2018 were retrospectively analyzed.According to different treatment methods,they were divided into the control group(conventional open surgery)and the experimental group(laparoscopy combined with cholangioscopy),with 30 cases in each group.The surgical status(surgical time,stone removal rate,intraoperative blood loss),postoperative recovery(postoperative analgesia time,gastrointestinal recovery time,T-tube clamping time,abdominal tube removal time)and the occurrence of complications were recorded in the two groups.Results There was no significant difference in the surgical time between the two groups(P>0.05).The stone removal rate in the experimental group was significantly higher than that in the control group(P<0.05).And the intraoperative blood loss was significantly lower than that in control group(P<0.05).The postoperative analgesia time,gastrointestinal recovery time,T-tube clamping time and abdominal tube removal time in experimental group were significantly lower than those in the control group(all P<0.05).The total incidence rate of complications such as bile leakage,hemobilia and biliary tract infection in experimental group was significantly lower than that in control group(P<0.05).Conclusion Compared with traditional open surgery,laparoscopy combined with cholangioscopy in treatment of intra and extrahepatobiliary tract stones has less trauma,high stone removal rate and fewer complications.

关 键 词：腹腔镜 胆道镜 肝内外胆管结石 安全性 

分 类 号：R657.4[医药卫生—外科学]