腹腔镜再次胆道手术治疗胆总管结石的有效性及安全性分析  

Efficacy and safety of repeat biliary surgery for common bile duct stones by laparoscopic procedure

作　　者：夏艳军 Xia Yanjun(Traditional Chinese medicine hospital of Shangshui County,Henan Shangshui,466100,China)

机构地区：[1]河南省商水县中医院,河南商水466100

出　　处：《辽宁医学杂志》2021年第4期64-66,共3页Medical Journal of Liaoning

摘　　要：目的分析腹腔镜再次胆道手术治疗胆总管结石患者的有效性及安全性。方法选择2017年5月至2018年8月商水县中医院外科接收的90例有胆道手术史需再行手术治疗的胆总管结石患者90例,根据手术方式分为腹腔镜组(45例,行腹腔镜手术治疗)和开腹组(45例,行开腹手术治疗),比较两组手术相关指标及术后并发症情况。结果腹腔镜组手术用时短于开腹组[(110.9±23.1)VS(121.3±17.6)]min,术中出血量少于开腹组[(65.2±17.1)VS(109.7±14.9)]ml,胃肠道功能恢复用时短于开腹组[(24.6±2.4)VS(55.1±5.9)]h,住院时间短于开腹组[(6.1±1.2VS11.7±1.9)]d,差异均有统计学意义(P<0.05);术后镇痛例数、切口感染发生率比较,腹腔镜组较开腹组更少(或低),分别为(4例VS 12例)、(2.22%VS 17.78%),差异均有统计学意义(P<0.05);两组结石残留、胆瘘、胆道狭窄、结石复发等情况比较,差异均无统计学意义(P>0.05)。结论对有胆道手术史的总管结石患者行腹腔镜再次胆道手术治疗,具有手术用时短、出血少、疼痛轻等优点,手术安全性高,临床可推广使用。Objective To analyse the efficacy and safety of repeat biliary surgery for recurrent choledocholithiasis through laparoscopic procedure.Methods 90 patients who had history of biliary tract surgery for bile duct stones and required repeat operation for recurrent choledocholithiasis were selected in traditional Chinese medicine hospital of Shangshui from May 2017 to August 2018,Randomly divided into laparoscopic group(45 cases,laparoscopic surgery)and open group(45 cases,open operation),The main surgical variables and postoperative complications between the two groups were compared.Results The operation time of laparoscopy group was shorter than that of open group[(110.9±23.1)VS(121.3±17.6)]min,The amount of intraoperative bleeding was less than that of the open group[(65.2±17.1)VS(109.7±14.9)]ml,The recovery time of gastrointestinal function was shorter than that of the open group[(24.6±2.4)VS(55.1±5.9)]h,the length of postoperative hospital stay was shorter than that of the open group[(6.1±1.2 VS11.7±1.9)]d,The difference was statistically significant(P<0.05);The number of patients using analgesics,and the incidence of wound infection in laparoscopic group were lower than those in laparotomy group,They were respectively(4 cases vs 12 cases)and(2.22%vs 17.78%),The difference was statistically significant(P<0.05);While the residual stone,incidence of bile leakage,biliary stricture,and stone recurrence showed no statistical difference between the two groups(P>0.05).Conclusion For the patients who had history of biliary tract surgery for bile duct stones and required repeat operation for recurrent choledocholithiasis,Laparoscopic reoperation of biliary tract has the short operation time,less bleeding,less pain and so on.The operation with high safety and can be widely used in clinic.

关 键 词：腹腔镜 胆道外科手术 胆总管结石 

分 类 号：R657.4[医药卫生—外科学]