腹腔镜与胆道镜联合胆总管探查取石术治疗胆囊结石伴胆总管结石的效果  

Effect of Laparoscopic Choledochoscope Combined with Choledochoscope Exploration and Lithotomy for Cholecystolithiasis with Choledochoolithiasis

作　　者：林瑞蔼 张平 彭晓锋 Lin Ruiai;Zhang Ping;Peng Xiaofeng(Second Department of Surgery,Lufeng People's Hospital,Lufeng 516500,Guangdong Province,China)

机构地区：[1]陆丰市人民医院外二科,广东陆丰516500

出　　处：《中外医药研究》2024年第33期12-14,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:探究腹腔镜与胆道镜联合胆总管探查取石术治疗胆囊结石伴胆总管结石的效果。方法:选取2022年10月—2024年5月于陆丰市人民医院接受治疗的60例胆囊结石伴胆总管结石患者为研究对象,按照随机数字表法将患者分为开腹组(n=30)和双镜取石组(n=30)。开腹组采用开腹手术治疗,双镜取石组采取腹腔镜与胆道镜联合胆总管探查取石术治疗。对比两组手术指标、术后恢复指标情况、肝功能指标水平及术后并发症发生情况。结果:双镜取石组术中出血量少于开腹组,手术时间短于开腹组(P<0.001);双镜取石组术后首次进食时间早于开腹组,术后住院时间短于开腹组(P<0.05);术后3个月,两组γ-谷氨酰转肽酶、总胆红素及丙氨酸氨基转移酶水平降低,双镜取石组低于开腹组(P<0.05);两组术后并发症总发生率对比,无统计学差异(P>0.05)。结论:腹腔镜与胆道镜联合胆总管探查取石术治疗胆囊结石伴胆总管结石的效果显著,可缩短手术时间,减少术中出血量,加速术后恢复,改善肝功能,降低术后并发症发生风险。Objective:To explore the effect of laparoscopic choledochoscope combined with choledochoscope exploration and lithotomy in the treatment of cholecystolithiasis with choledochoolithiasis.Methods:Sixty patients with cholecystolithiasis combined with choledocholithiasis who were treated in Lufeng People's Hospital from October 2022 to May 2024 were selected as the study objects.According to random number table method,the patients were divided into laparotomy group(n=30)and double mirror lithotomy group(n=30).Laparotomy was performed in the laparotomy group,and laparoscopic choledochoscopy combined with choledochoscopy was performed in the double mirror lithotomy group.The surgical indexes,postoperative recovery indexes,liver function indexes and postoperative complications were compared between the two groups.Results:The amount of blood loss and the time of operation in the double mirror lithotomy group were shorter than those in the laparotomy group(P<0.001);the first feeding time of the double mirror lithotomy group was earlier than that of the laparotomy group,and the postoperative hospital stay was shorter than that of the laparotomy group(P<0.05);at 3 months after operation,the levels ofγ-glutamyltranspeptidyase,total bilirubin and alanine aminotransferase in 2 groups were decreased,and those in double mirror lithotomy group were lower than those in laparotomy group(P<0.05);there was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion:Laparoscopic choledochoscopy combined with choledochoscopy has significant effects in the treatment of cholecystolithiasis and choledocholithiasis,which can shorten operation time,reduce intraoperative blood loss,accelerate postoperative recovery,improve liver function,and reduce the risk of postoperative complications.

关 键 词：胆囊结石 胆总管结石 腹腔镜 胆道镜 胆总管探查取石术 

分 类 号：R657.42[医药卫生—外科学]