保胆术与切除术在胆囊结石治疗中的应用  

Application of Choledocholithotomy and Cholecystectomy in the Treatment of Cholecystolithiasis

作　　者：安华松 王建 袁赵 徐海 杨波 AN Huasong;WANG Jian;YUAN Zhao;XU Hai;YANG Bo(Department of Hepatobiliary and Pancreatic Surgery,the Second Affiliated Hospital of Xuzhou Medical University,Xuzhou Jiangsu 221004,China)

机构地区：[1]徐州医科大学第二附属医院肝胆胰外科,江苏徐州221004

出　　处：《中国继续医学教育》2021年第35期86-90,共5页China Continuing Medical Education

摘　　要：目的探讨保胆术与切除术在胆囊结石治疗中的应用效果。方法选择2017年6月—2020年5月本院收治的50例胆囊结石患者作为研究对象,以随机数字表法将其分为两组,其中对照组与研究组各25例。对照组行腹腔镜下胆囊切除术,研究组行腹腔镜下保胆取石术。对比两组手术情况(手术时间、术中失血量)、术后情况(首次排气时间与术后住院时间)、结石一次性取净率、术后近期并发症情况、术后远期并发症情况。结果研究组手术时间明显长于对照组(P <0.01);两组术中失血量对比差异无统计学意义(P> 0.05);研究组首次排气、术后住院时间明显短于对照组(P <0.01)。两组结石一次性取净率对比差异无统计学意义(P> 0.05)。两组术后近期并发症发生率对比差异无统计学意义(P> 0.05)。随访1年,研究组总并发症发生率12.00%明显低于对照组40.00%(P <0.05)。结论保胆术与胆囊切除术治疗胆囊结石的效果相当,但保胆术利于患者恢复,且远期并发症风险更低,有临床应用价值。Objective To investigate the application effect of cholecystolithiasis treated by choledocholithotomy and cholecystectomy. Methods 50 patients with gallstone from June 2017 to May 2020 were randomly divided into control group and study group with 25 cases in each group. The control group underwent laparoscopic cholecystectomy, and the study group underwent laparoscopic cholecystectomy.Results The operation time in the study group was longer than that in the control group(P<0.01);there was no difference in blood loss between the two groups(P>0.05);the first exhaust and postoperative hospital stay in the study group were lower than those in the control group(P<0.01).There was no difference in the stone clearance rate between the two groups(P>0.05). There was no difference in the incidence of postoperative complications between the two groups(P>0.05). The long-term complication rate of the study group was 12.00% lower than that of the control group 40.00%(P<0.05). Conclusion Choledocholithotomy and cholecystectomy have the same effect on the treatment of gallstones, but choledocholithotomy is conducive to the recovery of patients, and the risk of long-term complications is lower, which has clinical value.

关 键 词：保胆手术 胆囊切除术 胆囊结石 取净率 近期并发症 远期并发症 

分 类 号：R575[医药卫生—消化系统]