腹腔镜胆道探查术与传统开腹手术治疗胆囊结石合并胆总管结石的临床效果比较  

Comparison of clinical effects of laparoscopic common bile duct exploration and traditional open surgery in the treatment of cholecystolithiasis complicated with choledocholithiasis

作　　者：马建政 MA Jianzheng(Department of General Surgery,Ningxian Hospital of Traditional Chinese Medicine,Qingyang,Gansu 745200,China)

机构地区：[1]宁县中医医院普外科,甘肃庆阳745200

出　　处：《医药前沿》2025年第4期79-82,共4页Journal of Frontiers of Medicine

摘　　要：目的比较腹腔镜胆道探查术与传统开腹手术治疗胆囊结石合并胆总管结石患者的临床效果。方法选取2022年2月—2023年2月宁县中医医院收治的胆囊结石合并胆总管结石患者84例,根据治疗方式不同分为观察组和对照组各42例。观察组采用腹腔镜胆道探查术,对照组采用传统开腹手术。比较两组患者的临床指标、结石全部清除率、视觉模拟评分法(VAS)评分、并发症发生率、应激反应指标。结果观察组切口长度、手术时间、术中出血量、术后排气时间和住院时间短于或少于对照组;术后结石全部清除率高于对照组,VAS评分和并发症总发生率低于对照组,应激反应指标低于对照组,差异有统计学意义(P<0.05)。结论与传统开腹手术比较,采用腹腔镜胆道探查术治疗胆囊结石合并胆总管结石患者创伤小,可缩短手术时间和住院时间,减轻疼痛,提高结石清除率,减少应激反应,促进患者恢复。Objective To compare the clinical effects of laparoscopic common bile duct exploration and traditional open surgery in the treatment of patients with cholecystolithiasis and choledocholithiasis.Methods A total of 84 patients with cholecystolithiasis complicated with choledocholithiasis admitted to Ningxian Hospital of Traditional Chinese Medicine from February 2022 to February 2023 were selected and divided into observation group and control group according to different treatment methods,with 42 cases in each group.The observation group was treated with laparoscopic common bile duct exploration,and the control group was treated with traditional open surgery.The clinical indexes,total stone clearance rate,Visual Analogue Scale(VAS)score,complication rate and stress response index were compared between the two groups.Results The incision length,operation time,intraoperative bleeding loss,postoperative exhaust time and hospitalization time of the observation group were shorter or less than those of the control group;the postoperative total stone clearance rate was higher than that of the control group,the VAS score and the total incidence of complications were lower than those of the control group,and the stress response index was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusions Compared with traditional open surgery,laparoscopic common bile duct exploration in the treatment of patients with cholecystolithiasis complicated with choledocholithiasis has less trauma,which can shorten the operation time and hospitalization time,reduce pain,improve the stone clearance rate,reduce stress response,and promote the recovery of patients.

关 键 词：腹腔镜胆道探查术 传统开腹手术 胆囊结石 胆总管结石 疼痛 白细胞介素-6 C反应蛋白 

分 类 号：R657[医药卫生—外科学]