术中胆道造影在腹腔镜联合胆道镜保胆取石术中的应用效果  

Application of intraoperative cholangiography in laparoscopic combined with choledochoscopic gallbladder-preserving cholesystoli-thotomy

作　　者：陈炳荣 郁盛诚 周海军[1] CHEN Bingrong;YU Shengcheng;ZHOU Haijun(Department of General Surgery,Jiaxing Traditional Chinese Medicine Hospital,Jiaxing 314000,China)

机构地区：[1]嘉兴市中医医院普外科,314000

出　　处：《浙江医学》2022年第8期863-865,869,共4页Zhejiang Medical Journal

基　　金：嘉兴市科技计划项目(2021AD30035)。

摘　　要：目的探讨术中胆道造影在腹腔镜联合胆道镜保胆取石术中的应用效果。方法选取2020年1至12月嘉兴市中医医院收治的胆囊结石患者90例,采用随机数字表法将其分为观察组和对照组,每组45例。观察组患者在行腹腔镜联合胆道镜保胆取石术中采用术中胆道造影;对照组患者则未使用术中胆道造影,仅行腹腔镜联合胆道镜取石术治疗。记录并比较两组患者手术时间、术中出血量、住院时间、手术成功率、术后并发症发生率、术前和术后6个月胆囊收缩功能变化以及术后6个月胆囊结石复发情况。结果观察组患者手术时间明显长于对照组,住院时间明显短于对照组,差异均有统计学意义(均P<0.05);两组患者术中出血量、手术成功率、胆囊结石复发率比较差异均无统计学意义(均P>0.05)。观察组患者术后并发症发生率明显低于对照组,差异有统计学意义(P<0.05)。两组患者术后6个月胆囊收缩率较术前均明显提高,差异均有统计学意义(均P<0.05);观察组患者术后6个月胆囊收缩率明显高于对照组,差异有统计学意义(P<0.05)。结论术中胆道造影在腹腔镜联合胆道镜保胆取石术应用效果良好,可明显提高手术成功率,降低术后并发症发生率,改善胆囊收缩功能。Objective To investigate the application of intraoperative cholangiograph in laparoscopy combined with choledochoscopic gallbladder-preserving cholesystolithotomy.Methods Ninety patients with gallbladder stones who were scheduled to undergo laparoscopc combined with choledochoscopic gallbladder-preserving cholesystolithotomy in Jiaxing Hospital of Traditional Chinese Medicine from January 2020 to December 2020 were enrolled.Patients were randomly divided into two groups with 45 cases in each group,the intraoperative cholangiography was performed in study group and was not performed in control group.The operation time,intraoperative blood loss,postoperative hospital stay,postoperative complications,success rate of the operation and the recurrent rate 6 months after operation were compared between the two groups.And the changes in gallbladder contraction function before and 6 months after operation were compared between the two groups.Results The operation time was longer and the postoperative hospital stay was shorter in study group than those in control group(P<0.05).There were no significant differences in intraoperative blood loss,operation success rate and recurrent rate between two groups(P>0.05).The postoperative complication rate in study group was lower than that in control group(P<0.05).Compared to that before surgery the contractile function of the gallbladder was significantly increased 6 months after surgery in both groups(P<0.05),while the contractile function after surgery in the study group was higher than that in control group(P<0.05).Conclusion Intraoperative cholangiography is effective in laparoscopic combined choledochoscopic gallbladder-preserving cholesystolithotomy,which can increase the success rate of the operation,reduce postoperative complications,and improve the contractile function of the gallbladder.

关 键 词：术中胆道造影 腹腔镜 胆道镜 保胆取石术 胆囊结石 

分 类 号：R657.42[医药卫生—外科学]