腹腔镜联合胆道镜手术对胆总管并胆囊结石术后并发症、预后恢复的影响  

Impacts of laparoscopy combined with cholangioscopy on postoperative complications and prognosis of choledocholithiasis complicated with gallbladder stones

作　　者：刘剑 LIU Jian(DepartmentⅠof General Surgery,the First Hospital of Qinhuangdao City in Hebei Province,Qinhuangdao 066000,China)

机构地区：[1]河北省秦皇岛市第一医院普外一科,河北秦皇岛066000

出　　处：《中国现代医生》2021年第1期47-50,共4页China Modern Doctor

摘　　要：目的探讨胆总管合并胆囊结石患者应用腹腔镜联合胆道镜手术治疗的临床疗效及安全性。方法选取2019年1月至2020年1月在我院行外科手术治疗的胆总管并胆囊结石患者80例,采用随机数字表法将其均等分为对照组及观察组,每组各40例。对照组采用开腹胆囊切除术联合胆总管取石术并T管引流方案,观察组采用腹腔镜胆囊切除术联合胆总管探查术并T管引流方案。分析两组患者临床资料及手术相关数据,评价不同方案对患者术后并发症、预后恢复的影响。结果两组手术时间比较,差异无统计学意义(P>0.05);观察组术中出血量、肛门排气时间、住院时间少于对照组,差异有统计学意义(P<0.05);术后对两组患者进行平均时间为2周的随访,记录术后并发症发生情况,包括胆漏、胆道感染、胰腺炎、结石复发,观察组术后并发症发生率为2.5%,显著低于对照组的20.0%,差异有统计学意义(P<0.05)。结论胆总管并胆囊结石患者应用腹腔镜联合胆道镜手术治疗,在安全性、有效性方面均有突出价值,值得推广。Objective To investigate the clinical efficacy and safety value of laparoscopy and cholangioscopy surgery for patients with choledocholithiasis complicated with gallbladder stones.Methods A total of 80 patients with choledocholithiasis complicated with gallbladder stones treated with surgery admitted to our hospital were selected.The time span was from January 2019 to January 2020.They were equally divided into the control group(n=40)and the observation group(n=40)by the random number table method.Open cholecystectomy combined with choledocholithotomy and T-tube drainage intervention program were proposed in the control group,while laparoscopic cholecystectomy combined with common bile duct exploration and T-tube drainage were proposed in the observation group.Through the analysis of the clinical and operation data of patients under the two treatment schemes,the postoperative complications and prognosis were evaluated.Results There was no significant difference between the two groups in terms of operation duration(P>0.05).The intraoperative hemorrhage volume,anal exhaust time and postoperative hospitalization time of the observation group were shorter than that of the control group,the differences were statistically significant(P<0.05).After the operation,the patients in both groups were followed up for an average of 2 weeks,and the postoperative complications,including bile leakage,biliary tract infection,pancreatitis and stone relapse,were recorded.The incidence rate of the observation group was 2.5%,which was significantly lower than 20.0%of the control group,the difference was statistically significant(P<0.05).Conclusion Considering the safety and effectiveness,there is outstanding value in the application of laparoscopy combined with cholangioscopy for patients with choledocholithiasis complicated with gallbladder stones,which is worthy of promotion.

关 键 词：腹腔镜 胆道镜 胆囊结石 胆总管结石 

分 类 号：R575.6[医药卫生—消化系统]