腹腔镜胆囊切除联合胆道镜经胆囊管探查取石术对胆囊合并胆总管结石患者手术相关指标及并发症的影响  

The Effect of Laparoscopic Cholecystectomy Combined with Choledochoscopy for Exploration and Removal of Stones Through the Cystic Duct on Surgical Related Indicators and Complications in Patients with Gallbladder and Common Bile Duct Stones

作　　者：牛其新 吴争光 牛建广 NIU Qi-xin;WU Zheng-guang;NIU Jian-guang(Department of General Surgery,Xiangcheng Hospital of Traditional Chinese Medicine,Xiangcheng 466200,Henan Province,China)

机构地区：[1]河南省项城市中医院普外科,河南项城466200

出　　处：《罕少疾病杂志》2024年第2期65-67,共3页Journal of Rare and Uncommon Diseases

基　　金：河南医学科技攻关计划联合共建项目(LHGJ20203074)。

摘　　要：目的探讨腹腔镜胆囊切除(LC)联合胆道镜经胆囊管探查取石术(LTCBDE)治疗胆囊合并胆总管结石患者的应用价值。方法选取2020年8月至2022年8月我院收治的96例胆囊合并胆总管结石患者为研究对象,基于随机数字表法规范化分为两组各48例,对照组实行开腹手术,观察组实行微创手术即LC+LTCBDE,观察对比两组手术相关指标、术后并发症发生率、炎症因子水平、肝功能指标。结果与对照组做对比,观察组术中出血量低,手术用时短,术后下床活动、肛门排气及住院时间均更短(P<0.05);与对照组做对比,观察组术后并发症发生率低(P<0.05);术后3d,两组CRP、IL-6、TNF-α、AMY水平均升高,其中观察组较对照组相对低(P<0.05);术后,两组AST、ALT、TBi L、ALP水平均升高,且术后3d观察组以上指标均较对照组低(P<0.05)。结论胆囊合并胆总管结石患者实施LC+LTCBDE治疗,相较于开腹胆囊切除胆总管探查术(OCBDE),患者损伤小,便于恢复,且并发症风险低,加快术后康复进程,其治疗安全性及有效性兼顾。Objective To explore the application effect of laparoscopic cholecystectomy(LC)combined with choledochoscopy through cystic duct exploration(LTCBDE)in the treatment of patients with gallbladder and common bile duct stones.Methods The participants in the study were patients with gallbladder and common bile duct stones,who were admitted to the hospital from August 2020 to August 2022.They were divided into two groups according to the principle of random number table-control group and observation group.The former group underwent open surgery,and the latter group underwent minimally invasive surgery,namely LC+LTC BDE;The operation-related indexes,postoperative complication rate,inflammatory reaction index and liver function index of the two groups were evaluated and compared.Results Compared with the control group,the amount of bleeding in the observation group was low,the operation time was short,and the postoperative ambulation,anal exhaust and hospitalization time were short(P<0.05).Compared with the control group,the rate of postoperative complications in the observation group was lower(P<0.05).On the 3rd day after operation,CRP,IL-6,TNF-α and AMY in both groups showed an upward trend,and the increase in the observation group was relatively small(P<0.05).After operation,AST,ALT,TBiL and ALP in both groups showed an increasing trend,and the above indexes in the observation group were even lower 3 days after operation(P<0.05).Conclusion Compared with traditional laparotomy,LC+LTCBDE can reduce the probability of body damage and postoperative complications,on the other hand,it can promote early postoperative recovery,and its treatment is both safe and effective.

关 键 词：腹腔镜胆囊切除 胆道镜经胆囊管探查取石术 胆囊结石 胆总管结石 手术相关指标 并发症 

分 类 号：R575.6[医药卫生—消化系统]