腹腔镜下经胆囊管胆道取石术与胆总管切开取石术治疗胆囊结石合并胆管结石的效果对比  

Comparison of the Effect of Laparoscopic Transcystic Duct Biliary Lithotomy and Choledocholithotomy in the Treatment of Gallstone Combined with Calculus of Bile Duct

作　　者：丁军[1] 毛栋华 DING Jun;MAO Donghua(The Fifth People's Hospital of Changshu,Changshu 215500,China;不详)

机构地区：[1]常熟市第五人民医院,江苏常熟215500

出　　处：《中外医学研究》2024年第3期13-16,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:比较腹腔镜下经胆囊管胆道取石术与胆总管切开取石术治疗胆囊结石合并胆管结石的效果。方法:选取2017年12月—2022年12月于常熟市第五人民医院行手术治疗的102例胆囊结石合并胆管结石患者,通过随机分组法分为试验组和常规组,各51例。常规组采取胆总管切开取石术治疗,试验组采用腹腔镜下经胆囊管胆道取石术治疗。比较两组围手术期指标、炎症指标[白细胞介素-6(IL-6)、C反应蛋白(CRP)]及并发症发生率。结果:试验组术中出血量少于常规组,手术时间、住院时间短于常规组,差异有统计学意义(P<0.05)。术前,两组IL-6、CRP水平比较,差异无统计学意义(P>0.05);术后12 h,两组IL-6、CRP高于术前,但试验组均低于常规组,差异有统计学意义(P<0.05)。试验组并发症总发生率低于常规组,差异有统计学意义(P<0.05)。结论:与胆总管切开取石术相比,腹腔镜下经胆囊管胆道取石术治疗胆囊结石合并胆管结石患者可缩短手术时间、住院时间,加速术后康复。Objective:To compare the effect of laparoscopic transcystic duct biliary lithotomy and choledocholithotomy in the treatment of gallstone combined with calculus of bile duct.Method:A total of 102 patients with gallstone combined with calculus of bile duct underwent surgical treatment in the Fifth People's Hospital of Changshu from December 2017 to December 2022 were selected and divided into experimental group and conventional group by random grouping method,with 51 cases in each group.The conventional group was treated with cholecystolithotomy,and the experimental group was treated with laparoscopic transcystic duct biliary lithotomy.The perioperative indexes,inflammatory indexes[interleukin-6(IL-6),C-reactive protein(CRP)]and complication rate between the two groups were compared.Result:The intraoperative blood loss of experimental group was less than that of conventional group,and the surgical time and hospital stay of experimental group were shorter than those of conventional group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in IL-6 and CRP levels between the two groups(P>0.05).At 12 h after surgery,IL-6 and CRP in two groups were higher than those before surgery,but those in experimental group were lower than those in conventional group,the differences were statistically significant(P<0.05).The total incidence of complications in experimental group was lower than that in conventional group,and the difference was statistically significant(P<0.05).Conclusion:Compared with cholecystolithotomy,laparoscopic transcystic duct biliary lithotomy for patients with gallstone combined with calculus of bile duct can shorten the surgical time and hospital stay,and accelerate postoperative rehabilitation.

关 键 词：胆囊结石合并胆管结石 术中出血量 手术时间 住院时间 腹腔镜下经胆囊管胆道取石术 炎症指标 并发症发生率 

分 类 号：R657.4[医药卫生—外科学]