腹腔镜联合一期吻合术对胆囊合并胆总管结石的疗效  

Effect of Laparoscopic Combined With One-Stage Anastomosis on Cholecystolithiasis

作　　者：陆颖超 焦健 张洪宜 黄锦山 LU Yingchao;JIAO Jian;ZHANG Hongyi;HUANG Jinshan(Department of Hepatobiliary Surgery,the First People's Hospital of Taicang,Taicang Jiangsu 215400,China;Department of General Surgery,Zhouzhi County People's Hospital,Zhouzhi Shaanxi 710499,China)

机构地区：[1]江苏省太仓市第一人民医院肝胆外科,江苏太仓215400 [2]陕西省周至县人民医院普外科,陕西周至710499

出　　处：《中国卫生标准管理》2023年第3期128-131,共4页China Health Standard Management

摘　　要：目的对临床胆囊合并胆总管结石患者,应用腹腔镜联合一期吻合术治疗效果进行研究。方法研究样本,来源于太仓市第一人民医院确诊胆囊合并胆总管结石患者,共计100例,搜集时间2018年1月—2021年10月,按随机数字表法进行分组,接受常规开腹手术(n=40)患者纳入对照组,接受腹腔镜联合胆道镜胆总管一期吻合术(n=60)患者纳入研究组,对比两组最后临床效果。结果研究组手术时间、胃肠道功能恢复时间、引流时间短于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05);研究组并发症发生率较对照组较低,差异有统计学意义(P<0.05)。结论胆囊合并胆总管结石患者的临床治疗方案,以腹腔镜联合胆道镜为主,同时在结合患者个体情况取石完整的情况下行胆总管一期吻合术,在缩短手术、胃肠道功能恢复,以及引流时间方面效果明显,促进患者治疗效果提升基础上,减少出现并发症的可能。Objective To study the effect of laparoscopy combined with one-stage anastomosis in the treatment of clinical gallbladder with choledocholithiasis.Methods A total of 100 cases of patients with gallbladder and choledocholithiasis diagnosed by the First People’s Hospital of Taicang were collected from January 2018to October 2021.They were grouped according to the random number table method.Patients who received conventional laparotomy(n=40)were included in the control group,and patients who received laparoscopic combined choledochoscopy primary choledocholithostomy(n=60)were included in the study group.The final clinical effects of the two groups were compared.Results The operation time,gastrointestinal function recovery time and drainage time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The complication rate of the study group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The clinical treatment plan of patients with gallbladder and choledocholithiasis is mainly laparoscopy combined with choledochoscopy,and the primary choledocholithostomy is performed in combination with the individual condition of the patients with complete stone removal,which has obvious effect in shortening the operation,gastrointestinal function recovery,and drainage time,promoting the improvement of the treatment effect of patients,and reducing the possibility of complications.

关 键 词：胆囊结石 胆总管结石 腹腔镜 胆道镜胆总管一期吻合术 胃肠道功能 反流性胃管炎 

分 类 号：R656[医药卫生—外科学]