改良腹腔镜联合胆管镜手术治疗肝外胆管系统结石的效果观察  

Analysis of the effect of modified laparoscopy combined with choledochoscopy in the treatment of extrahepatic cholelithiasis

作　　者：钱长春 Qian Changchun(The First People's Hospital of Yancheng City,Yancheng,Jiangsu224000)

机构地区：[1]盐城市第一人民医院,江苏盐城224000

出　　处：《基层医学论坛》2020年第22期3122-3124,共3页The Medical Forum

摘　　要：目的探讨改良腹腔镜联合胆管镜手术治疗肝外胆管系统结石的临床效果。方法选取2017年1月—2018年12月我院收治的肝外胆管系统结石患者60例,经随机数字表法分成对照组及观察组,每组30例。对照组行常规四孔腹腔镜手术,观察组行改良腹腔镜联合胆管镜手术,比较2组手术指标、术后疼痛评分及并发症发生情况。结果观察组手术时间、术后进食时间、术后排气时间、术后引流管放置时间、住院时间均短于对照组(P<0.05);观察组术中出血量低于对照组(P<0.05);观察组术后6 h、1 d的VAS评分低于对照组(P<0.05);观察组术后并发症总发生率低于对照组(P<0.05)。结论改良腹腔镜联合胆管镜手术治疗肝外胆管系统结石疗效确切,可加快术后恢复,缓解术后疼痛,降低并发症发生率。Objective To analyze the clinical effect of modified laparoscopy combined with choledochoscopy in the treatment of extrahepatic cholelithiasis.Methods from January 2017 to December 2018,60 patients with extrahepatic cholelithiasis were randomly divided into control group(n≤30)and observation group(n≤30).The patients were treated with conventional four-hole laparoscopy and modified laparoscopy combined with choledochoscopy.Results The duration of operation,the time of the first eating after operation,the time of the first exhaust after operation,the time of drainage tube placement after operation,and the time of in-hospital treatment in the observation group were shorter than those in the control group,and the difference was statistically significant(P<0.05);the amount of postoperative bleeding in the observation group was lower than that in the control group.Compared with the control group and the observation group 6 hours after operation,the VAS score level in the observation group was lower at 1 day after operation(P<0.05);the amount of intraoperative bleeding in the observation group was lower than that in the control group(P<0.05).Conclusion modified laparoscopy and choledochoscopy can achieve good clinical results in the treatment of extrahepatic cholelithiasis.

关 键 词：肝外胆管系统结石 改良腹腔镜 胆管镜 临床疗效 

分 类 号：R657.4[医药卫生—外科学]