“三镜”联合手术治疗老年与非老年胆总管结石合并胆囊结石的效果对比  

Comparison of therapeutic efficacy of triple-endoscopic surgery for common bile duct stones combined with gallbladder stones in elderly and non-elderly patients

作　　者：曹国军 唐勇 万赤丹 Cao Guojun;Tang Yong;Wan Chidan(Department of Hepatobiliary Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science&Technology,Hubei Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院肝胆外科,湖北武汉430022

出　　处：《腹部外科》2024年第1期64-68,共5页Journal of Abdominal Surgery

基　　金：国家重点研发计划(2022YFC2407402)。

摘　　要：目的探讨腹腔镜、胆道镜及十二指肠镜三镜联合微创手术对老年胆总管结石合并胆囊结石病人的治疗效果。方法回顾性分析自2020年9月至2022年7月因胆总管结石合并胆囊结石就诊于华中科技大学同济医学院附属协和医院,同期行腹腔镜、胆道镜及十二指肠镜三镜联合手术的病人,总计65例病人纳入本研究,男性36例,女性29例,年龄范围为20~87岁。其中老年组(年龄≥60岁)病人32例,非老年组(年龄<60岁)病人33例。收集病人手术时间、术中出血量、胆总管直径、术后住院时间、术后并发症、手术费用等临床数据。结果老年组总住院时间高于非老年组[(14.5±3.6)d比(12.5±4.3)d,P<0.05],在手术时间、术中出血量、首次进食时间、术后住院时间、住院费用及术后总并发症[12.5%(4/32)比6.1%(2/33)]方面,差异均无统计学意义(均P>0.05)。结论“三镜”联合术式在老年胆总管结石合并胆囊结石病人和非老年胆总管结石合并胆囊结石病人中效果无明显差异,对老年病人是一种安全、有效的术式。Objective To explore the therapeutic efficacy of three-port laparoscopic common bile duct stones combined with gallbladder stones surgery in elderly patients.Methods From September 2020 to July 2022,retrospective analysis was conducted for 65 patients undergoing laparoscopic,choledochoscopic and duodenoscopic three-port combined surgery for common bile duct stones and gallbladder stones.There were 36 males and 29 females with an age range of(20–87)years.They were assigned into two groups of elderly(n=32)and non-elderly(n=33).The relevant clinical data included operative duration,volume of blood loss,common bile duct diameter,postoperative hospitalization stay,postoperative complications and hospital expenses were collected.Results The total length of hospitalization stay was longer in elderly group than that in non-elderly group[(14.5±3.6)vs.(12.5±4.3)day].However,the differences were not statistically significant in operative duration,intraoperative volume of blood loss,postoperative hospitalization stay,hospital expenses or postoperative complications[12.5%(4/32)vs.6.1%(2/33)].Conclusion No significant difference exists in the efficacy of three-port combined surgery between elderly and non-elderly patients,making it a safe and effective procedure for elders.

关 键 词：腹腔镜 胆道镜 十二脂肠镜 胆总管结石 胆囊结石 老年病人 

分 类 号：R657.4[医药卫生—外科学]