胆结石伴肝外胆管结石患者腹腔镜胆囊切除术中十二指肠镜的作用分析  

Role of Duodenoscopy During Laparoscopic Cholecystectomy in Patients with Gallstones and Extrahepatic Bile Duct Stones

作　　者：瞿学栋 杨亮 李宝平 QU Xuedong;YANG Liang;LI Baoping(Department of Surgery,Chengguan District People's Hospital,Lanzhou 730030,Gansu,China)

机构地区：[1]兰州市城关区人民医院外科,甘肃兰州730030

出　　处：《世界复合医学(中英文)》2024年第10期119-122,共4页World Journal of Complex Medicine

摘　　要：目的 探析腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)联合十二指肠镜治疗胆结石伴肝外胆管结石的应用效果。方法 选取2022年8月—2023年11月兰州市城关区人民医院收治的72例胆结石伴肝外胆管结石患者为研究对象,按照手术方法不同分为对照组和观察组,各36例。对照组实施常规切开手术+T管引流术,观察组采用十二指肠镜联合LC手术,比较两组术后进食、胃肠功能恢复时间、手术时间、住院时间、胃肠功能及并发症发生情况。结果 观察组手术时间长于对照组,术后进食、胃肠功能恢复、住院时间短于对照组,差异均有统计学意义(P均<0.05)。术前1 d,两组胃泌素(gastrin,GAS)、胃动素(motilin,MTL)、二胺氧化酶(diamine oxidase,DAO)、D-乳酸水平比较,差异无统计学意义(P均>0.05);术后7 d,观察组GAS、MTL水平低于对照组,DAO、D-乳酸水平高于对照组,差异均有统计学意义(P均<0.05)。观察组并发症发生率为0,低于对照组的16.67%(6/36),差异有统计学意义(P<0.05)。结论 胆结石伴肝外胆管结石患者治疗期间,十二指肠镜联合LC手术能有效缩短患者的住院与术后恢复时间,安全性较高。Objective To explore the application effect of laparoscopic cholecystectomy(LC) combined with duodenoscopy in the treatment of patients with gallstones and extrahepatic bile duct stones.Methods A total of 72 patients with gallstones and extrahepatic bile duct stones admitted to Chengguan District People's Hospital of Lanzhou City from August 2022 to November 2023 were selected as the research objects.According to different surgical methods,they were divided into control group and observation group,with 36 cases in each group.The control group was treated with conventional incision surgery+T-tube drainage,and the observation group was treated with duodenoscopy combined with LC surgery.The postoperative feeding,gastrointestinal function recovery time,operation time,hospitalization time,gastrointestinal function and complications were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,and the postoperative feeding,gastrointestinal function recovery and hospitalization time were shorter than those of the control group,and the differences were statistically significant(all P<0.05).There were no statistically significant differences in gastrin(GAS),motilin(MTL),diamine oxidase(DAO) and D-lactic acid levels between the two groups 1 day before surgery(all P>0.05).Seven days after operation,GAS and MTL levels in observation group were lower than those in control group,DAO and D-lactic acid levels were higher than those in control group,and the differences were statistically significant(all P<0.05).The incidence of complications in the observation group was 0,which was lower than 16.67%(6/36) in the control group,and the difference was statistically significant(P<0.05).Conclusion During the treatment of patients with gallstones and extrahepatic bile duct stones,duodenoscopy combined with LC surgery can effectively shorten the hospitalization and postoperative recovery time of patients with high safety.

关 键 词：胆结石 肝外胆管结石 十二指肠镜 腹腔镜胆囊切除术 生存质量 

分 类 号：R657.42[医药卫生—外科学]