腹腔镜与传统开腹胆总管探查术在老年复发性胆总管结石治疗中的对比分析  

Comparative analysis of laparoscopic and traditional open common bile duct exploration in treating elderly recurrent common bile duct stones

作　　者：李晓华 Li Xiao-hua(Department of General Surgery,Wannian Hospital of Traditional Chinese Medicine,Shangrao 335500,Jiangxi,China)

机构地区：[1]万年县中医院普外科,江西上饶335500

出　　处：《四川生理科学杂志》2024年第6期1349-1351,共3页Sichuan Journal of Physiological Sciences

摘　　要：目的:分析腹腔镜与传统开腹胆总管探查术在老年复发性胆总管结石治疗中的效果。方法:纳入2022年12月~2023年12月期间我院收治的80例老年复发性胆总管结石患者,随机分为开腹组和腹腔镜组各40例,开腹组患者实施传统开腹胆总管探查术治疗,腹腔镜组患者实施腹腔镜下胆总管探查术治疗,比较两组患者手术情况[手术时间、切口长度、出血量]、术后恢复时间[下床时间、首次排气、住院时间]。比较两组患者手术前后应激指标水平[皮质醇(COR)、肾上腺素(A)]、肠道屏障功能水平[D-乳酸、内毒素]。结果:两组患者手术时间比较无明显差异(P>0.05);腹腔镜组切口长度、出血量、下床时间、首次排气、住院时间均显著低于开腹组(P<0.05)。术后两组患者COR、A、D-乳酸、内毒素水平均高于术前,但腹腔镜组显著低于开腹组(P<0.05)。结论:相较于传统开腹胆总管探查术,腹腔镜下胆总管探查术可缩小切口长度,减少出血量,对其肠道屏障功能影响较小,有利于患者术后快速康复。Objective:To analyze the effect of laparoscopic and traditional open common bile duct exploration in the treatment of elderly patients with recurrent common bile duct stones.Methods:80 elderly patients with recurrent common bile duct stones in the hospital were enrolled from December 2022 to December 2023,and were randomly divided into open group and laparoscopic group with 40 cases in each group.The patients in the open group were treated with traditional open common bile duct exploration,while the patients in the laparoscopic group received laparoscopic common bile duct exploration.The surgical conditions[surgical time,incision length,bleeding volume]and postoperative recovery status[ambulation time,first exhaust time,hospital stay]and levels of stress indicators[cortisol(COR),adrenaline(A)],intestinal barrier function[D-lactic acid,endotoxin]before and after surgery were compared between both groups of patients.Results:There was no significant difference in surgical time between the two groups(P>0.05).The incision length,bleeding volume,ambulation time,first exhaust time and hospital stay in laparoscopic group were significantly shorter or less than those in open group(P<0.05).The levels of COR,A,D-lactic acid and endotoxin in the two groups after surgery were higher than those before surgery,but the levels were significantly lower in laparoscopic group than those in open group(P<0.05).Conclusion:Compared with traditional open common bile duct exploration,laparoscopic common bile duct exploration can better shorten the incision length and reduce the bleeding volume,and the latter one has smaller effect on the intestinal barrier function and is more conducive to the postoperative rapid rehabilitation of patients.

关 键 词：腹腔镜 传统开腹胆总管探查术 老年复发性胆总管结石 术后恢复 

分 类 号：R657.4[医药卫生—外科学]