腹腔镜胆囊切除术联合胆总管探查术治疗胆囊结石合并胆总管结石的临床效果  

Clinical effect of laparoscopic cholecystectomy combined with common bile duct exploration in the treatment of cholecystolithiasis complicated with choledocholithiasis

作　　者：张维浩[1] ZHANG Weihao(Department of General Surgery,Gaoqing County People's Hospital,Zibo,Shandong 256300,China)

机构地区：[1]高青县人民医院普外科,山东淄博256300

出　　处：《医药前沿》2025年第7期55-57,61,共4页Journal of Frontiers of Medicine

摘　　要：目的 观察腹腔镜胆囊切除术联合胆总管探查术治疗胆囊结石合并胆总管结石的临床效果。方法 选取2022年1月—2023年6月高青县人民医院收治的84例胆囊结石合并胆总管结石患者,按照手术方法不同分为观察组(44例)和对照组(40例)。观察组和对照组分别采用腹腔镜胆囊切除术联合胆总管探查术和传统开腹手术。比较两组临床疗效、血清应激指标[皮质醇(COR)、促肾上腺皮质激素(ACTH)、肾上腺素(E)和去甲肾上腺素(NE)]水平、围术期指标及并发症发生情况。结果 治疗后,观察组总有效率高于对照组,COR、ACTH、E和NE水平低于对照组;观察组手术出血量和手术时间、胃肠蠕动恢复时间、下床活动时间、住院时间少于或短于对照组;住院期间,观察组并发症总发生率低于对照组(P<0.05)。结论 胆囊结石合并胆总管结石患者采用腹腔镜胆囊切除术联合胆总管探查术治疗效果良好,可缩短手术、住院和术后身体功能恢复时间,降低术后应激指标水平和并发症发生率。Objective To observe the clinical effect of laparoscopic cholecystectomy combined with common bile duct exploration in the treatment of cholecystolithiasis and choledocholithiasis.Methods A total of 84 patients with cholecystolithiasis and choledocholithiasis admitted to Gaoqing County People's Hospital from January 2022 to June 2023 were selected and divided into observation group(44 cases)and control group(40 cases)according to different surgical methods.The observation group and the control group were treated with laparoscopic cholecystectomy combined with common bile duct exploration and traditional open surgery,respectively.The clinical efficacy,serum stress indicators[cortisol(COR),adrenocorticotropic hormone(ACTH),epinephrine(E)and noradrenaline(NE)]levels,perioperative indicators and complications were compared between the two groups.Results After treatment,the total effective rate of the observation group was higher than that of the control group,and the levels of COR,ACTH,E and NE were lower than those of the control group.The operative blood loss,operation time,gastrointestinal motility recovery time,ambulation time and hospitalization time in the observation group were less or shorter than those in the control group.During hospitalization,the total incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusions Laparoscopic cholecystectomy combined with common bile duct exploration is effective in the treatment of patients with cholecystolithiasis and choledocholithiasis.It can shorten the recovery time of operation,hospitalization and postoperative physical function,and reduce the level of postoperative stress index and the incidence of complications.

关 键 词：腹腔镜胆囊切除术 胆总管探查术 胆囊结石 胆总管结石 肾上腺素 手术出血量 并发症 

分 类 号：R575[医药卫生—消化系统]