腹腔镜联合术中胆道镜治疗胆囊结石合并肝外胆管结石的疗效  

Treatment of Cholecystolithiasis with Extrahepatic Bile Duct Stones by Laparoscopy Combined with Intraoperative Choledochoscope

作　　者：邸亮[1] 赵晓飞[1] 丁兢[1] DI Liang;ZHAO Xiao-fei;DING Jing(General Surgery Center,Beijing You'an Hospital Affiliated to Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院普外中心,北京100069

出　　处：《医学信息》2021年第11期118-120,共3页Journal of Medical Information

摘　　要：目的观察腹腔镜联合术中胆道镜治疗胆囊结石合并肝外胆管结石的临床疗效。方法选取2018年5月~2020年5月在我院诊治的64例胆囊结石合并肝外胆管结石患者为研究对象,采用随机数字表法分为对照组和观察组,各32例。对照组行传统胆囊切除联合胆道切开取石治疗,观察组行腹腔镜联合术中胆道镜治疗,比较两组手术指标、结石残留率、术后疼痛(VAS)评分、并发症发生率。结果观察组手术时间、术中出血量、术后肛门排气时间、术后进食时间、术后下床活动时间、住院时间均小于对照组,差异有统计学意义(P<0.05);观察组结石残留率为6.25%,低于对照组的15.62%,差异有统计学意义(P<0.05);观察组术后VAS评分低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为9.37%,低于对照组的18.75%,差异有统计学意义(P<0.05)。结论腹腔镜联合术中胆道镜治疗胆囊结石合并肝外胆管结石有助于减少术中出血量,降低结石残留率及并发症发生率,缩短术后恢复时间,且术后疼痛小。Objective To observe the clinical effect of laparoscopy combined with intraoperative choledochoscopy in the treatment of gallbladder stones combined with extrahepatic bile duct stones.Methods 64 patients with gallbladder stones and extrahepatic bile duct stones diagnosed and treated in our hospital from May 2018 to May 2020 were selected as the research objects.Using random number table method,they were divided into control group and observation group,each with 32 cases.The control group underwent traditional cholecystectomy combined with biliary stone removal,and the observation group underwent laparoscopy combined with intraoperative choledochoscopy.The surgical indicators,residual stone rate,postoperative pain(VAS)score,and complication rate were compared between the two groups.Results The operation time,intraoperative blood loss,postoperative anus exhaust time,postoperative eating time,postoperative time to get out of bed,and hospital stay in the observation group were less than those of the control group,the difference was statistically significant(P<0.05);The residual rate of stones in the observation group was 6.25%,which was lower than15.62%in the control group,the difference was statistically significant(P<0.05);The postoperative VAS score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05);The incidence of complications in the observation group was 9.37%,which was lower than 18.75%in the control group,the difference was statistically significant(P<0.05).Conclusion Laparoscopy combined with intraoperative choledochoscopy for the treatment of gallbladder stones combined with extrahepatic bile duct stones can help reduce intraoperative blood loss,reduce the residual rate of stones and the incidence of complications,shorten postoperative recovery time,and reduce postoperative pain.

关 键 词：腹腔镜 胆道镜 胆囊结石 肝外胆管结石 

分 类 号：R657.4[医药卫生—外科学]