腹腔镜联合胆道镜微创治疗肝内外胆管结石的效果分析  

Analysis of the Effectiveness of Minimally Invasive Treatment of Intra-and Extrahepatic Bile Duct Stones by Laparoscopy Combined with Choledochoscopy

作　　者：赵晶晶[1] 俞权 周艳丽 何江[1] 卢崇梅 ZHAO Jingjing;YU Quan;ZHOU Yani;HE Jiang;LU Chongmei(Department of General Surgery,Dongtai People's Hospital,Dongtai,Jiangsu Province,224200 China)

机构地区：[1]东台市人民医院普外科,江苏东台224200

出　　处：《中外医疗》2023年第20期82-85,共4页China & Foreign Medical Treatment

摘　　要：目的 探讨腹腔镜联合胆道镜微创治疗肝内外胆管结石的临床有效性。方法 方便选取2019年5月—2023年2月东台市人民医院收治的71例肝内外胆管结石患者,对其临床资料进行回顾性分析,根据不同手术方式将其分为观察组和对照组,对照组36例,实施内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)术治疗,观察组35例,实施腹腔镜联合胆道镜取石术,对两组临床疗效,结石残留等进行比较。结果 观察组治疗后谷丙转氨酶和总胆红素水平显著低于对照组,差异有统计学意义(P<0.05)。对照组出血量及排气时间优于观察组,差异有统计学意义(P<0.05)。观察组结石残留率2.86%显著低于对照组22.22%,差异有统计学意义(χ^(2)=4.390,P<0.05);观察组术后并发症发生率与对照组比较,差异无统计学意义(P>0.05)。结论 ERCP与腹腔镜联合胆道镜微创治疗肝内外胆管结石均具有一定的效果,与ERCP相比,腹腔镜联合胆道镜治疗结石清除率高,但两者的安全性相当。Objective To explore the clinical effectiveness of laparoscopy combined with choledochoscopy for minimally invasive treatment of intra-and extrahepatic bile duct stones.Methods Seventy-one patients with intra-and extrahepatic bile duct stones admitted to Dongtai People's Hospital between May 2019 and February 2023 were conveniently selected and their clinical data were retrospectively analyzed.They were divided into an observation group and a control group according to different surgical methods,and 36 cases in the control group were treated with endoscopic retrograde cholangiopancreatography(ERCP).In the observation group of 35 cases,laparoscopic combined choledochoscopic lithotripsy was performed.The clinical efficacy,stone residue,etc.of the two groups were compared.Results After treatment,the levels of alanine aminotransferase and total bilirubin in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).The control group had better bleeding volume and exhaust time compared to the observation group,and the difference was statistically significant(P<0.05).The residual rate of stones in the observation group was 2.86%,which was significantly lower than that in the control group(22.22%),and the difference was statistically significant(χ^(2)=4.390,P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the observation group and the control group(P>0.05).Conclusion ERCP and laparoscopic combined cholangioscopy minimally invasive treatment of intra-and extrahepatic bile duct stones are both effective,compared with ERCP,laparoscopic combined cholangioscopy treatment of stone clearance rate is high,but the safety of both is equivalent.

关 键 词：腹腔镜 胆道镜 内镜逆行胰胆管造影 微创治疗 肝内外胆管结石 有效性 

分 类 号：R657[医药卫生—外科学]