腹腔镜再次胆道手术治疗胆总管结石的临床疗效分析  

Analysis of clinical efficacy of relaparoscopic common bile duct exploration for treatment of choledocholithiasis

作　　者：蒋星星[1] 罗翠松[1] 艾平岚 刘小琴[1] 曾三平 曾志峰[1] Jiang Xingxing;Luo Cuisong;Ai Pinglan;Liu Xiaoqin;Zeng Sanping;Zeng Zhifeng(Department of Hepatobiliary Surgery,The Affiliated Xinyu Hospital of Nanchang University,Xinyu,Jiangxi,338025,China)

机构地区：[1]江西省南昌大学附属新余医院肝胆外科,江西新余338025

出　　处：《当代医学》2020年第33期52-55,共4页Contemporary Medicine

基　　金：江西省新余市科技计划项目(20173090814)。

摘　　要：目的探讨腹腔镜再次胆道手术治疗胆总管结石的临床疗效及应用价值。方法回顾性分析2012年1月至2017年12月本院收治的86例有胆道手术史术后复发胆总管结石患者的临床资料,其中A组(n=40)行腹腔镜胆道再次手术,B组(n=46)行开腹胆道再次手术,比较两组住院时间、住院总费用、手术时间、胃肠道恢复时间及术后并发症。结果A组术后住院时间短于B组[(7.6±1.3)d vs.(13.2±2.8)d,P<0.05]、住院总费用少于B组[(1.32±0.05)万元vs.(1.73±0.03)万元,P<0.05]、胃肠道恢复时间短于B组[(24.6±2.8)h vs.(53.6±4.5)h,P<0.05]、术后镇痛少于B组(15.0%vs.43.5%,P<0.05)、切口感染率低于B组(2.5%vs.15.2%,P<0.05)。两组患者手术时间、术中出血量及术后胆漏发生率比较差异无统计学意义。结论腹腔镜再次胆道手术治疗胆总管结石临床疗效确切,具有创伤小、恢复快及并发症少等优点。Objective To investigate the clinical efficacy and application value of relaparoscopic common bile duct exploration for treatment of choledocholithiasis.Methods A retrospective analysis of the clinical data of 86 cases with common bile duct stones who had history of biliary tract surgery in our hospital from January 2012 to December 2017 was conducted.Group A(n=40)underwent laparoscopic biliary reoperation,and group B(n=46)underwent open biliary reoperation.The hospital stay,total cost of hospitalization,operation time,recovery time of gastrointestinal function and postoperative complications were compared between two groups.Results The postoperative hospital stay in group A was shorter than that in group B[(7.6±1.3)d vs.(13.2±2.8)d,P<0.05],the total cost of hospitalization was less than that of group B[(1.32±0.05)×10^4 vs.(1.73±0.03)×10^4 yuan,P<0.05],recovery time of gastrointestinal function was shorter than that in group B[(24.6±2.8)h vs.(53.6±4.5)h,P<0.05],postoperative analgesia was less than that in group B(15.0%vs.43.5%,P<0.05)and wound infection rate was lower than that in group B(2.5%vs.15.2%,P<0.05).There was no significant difference in the operation time,volume of intraoperative blood loss and postoperative bile leakage rate between the two groups.Conclusion Laparoscopic reoperation of the biliary tract for the treatment of choledocholithiasis is effective with advanteges of minimal trauma,quick recovery and fewer complications.

关 键 词：胆总管结石 再次胆道手术 临床疗效 

分 类 号：R657.4[医药卫生—外科学]