双镜联合治疗腹部手术史胆囊并胆总管结石的近期随访分析  

A recent follow-up analysis of cholecystolithiasis complicated by abdominal operation with dual-lens combined treatment

作　　者：邸亮[1] 郭庆良[1] 赵晓飞[1] 丁兢[1] 段斌炜[1] Di liang;Guo Qingliang;Zhao Xiaofei;Ding Jing;Duan Bingwei(Beijing Youan 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,100069

出　　处：《中华普外科手术学杂志（电子版）》2021年第4期440-443,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：北京市科技计划课题(Z181100001718143)。

摘　　要：目的探讨和分析腹腔镜与胆道镜双镜联合治疗腹部手术史胆囊并胆总管结石的近期随访状况。方法回顾性分析2017年7月至2020年6月具有腹部手术史的胆囊合并胆总管结石患者80例。其中20例予以传统开腹手术治疗(开腹组),60例患者予以腹腔镜与胆道镜双镜联合治疗(双镜组)。采用SPSS 22.0软件进行统计学分析,两组患者术中术后各项指标、术后止痛针使用次数等以(x±s)表示,采用独立样本t检验;两组患者治疗效果采用做秩和检验,术后近期并发症的发生率采用χ^(2)检验。P<0.05,差异有统计学意义。结果双镜组患者手术时间和治疗有效率大于开腹组(P<0.05),但术中出血量、术后止痛针使用次数、引流管留置时间、排气时间、肠道功能恢复时间、住院时间及胆管出血、胆漏、切口感染、腹腔感染、胰腺炎等近期并发症的发生率均明显低于开腹组(P<0.05)。结论双镜联合治疗腹部手术史胆囊并胆总管结石具有良好的治疗效果,可显著降低近期并发症发生率。Objective To investigate and analyze the recent follow-up of laparoscopic and choledochoscopy in the treatment of cholecystolithiasis with history of abdominal surgery.MethodsRetrospective analysis was performed on 80 patients with gallbladder and common bile duct stones who had abdominal surgery history were collected from July 2017 to June 2020.Among them,20 cases were treated with traditional open surgery(open group),and 60 cases were treated with laparoscopy combined with choledochoscope(double mirror group).SPSS 22.0 software was used for statistical analysis.The indexes during and after operation and the times of analgesic needle use in the two groups were expressed by (x±s),and the independent sample t test was used;the treatment effect of the two groups was tested by rank sum test,and the incidence of postoperative short-term complications was tested by chi square test.The difference was statistically significant(P<0.05).Results The operation time and effective rate of the double scope group were higher than those of the open group(P<0.05),but the intraoperative blood loss,postoperative analgesic needle use times,drainage tube indwelling time,exhaust time,intestinal function recovery time,hospitalization time,bile duct bleeding,bile leakage,incision infection,abdominal infection,pancreatitis and other recent complications in the double mirror group were significantly lower than those in the open group(P<0.05).Conclusion Double scope treatment has good therapeutic effect on choledocholithiasis and can significantly reduce the incidence of recent complications.

关 键 词：胆囊结石病 胆总管结石 腹腔镜 胆管镜 腹部手术史 随访研究 

分 类 号：R657.4[医药卫生—外科学]