腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石的安全性及有效性  

Safety and efficacy of laparoscopy combined with choledochoscopy in the treatment of cholecystolithiasis complicated with choledocholithiasis

作　　者：郑军[1] 杜文辉 邵齐 ZHENG Jun;DU Wenhui;SHAO Qi(Department of General Surgery,the Fourth Division Hospital of Xinjiang Production and Construction Corps,Yili,Xinjiang 835000,China)

机构地区：[1]新疆生产建设兵团第四师医院普外科,新疆伊犁835000

出　　处：《医药前沿》2025年第11期75-78,共4页Journal of Frontiers of Medicine

摘　　要：目的探讨腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石的安全性和有效性。方法选取2023年1—12月新疆生产建设兵团第四师医院收治的92例胆囊结石合并胆总管结石患者,按照随机数字表法分为观察组(n=46)与对照组(n=46)。对照组采用开腹手术,观察组采用腹腔镜联合胆道镜手术,比较两组手术指标、并发症及炎症因子水平。结果观察组手术时间、术后下床时间、首次肛门排气时间、住院时间均短于对照组,术中出血量少于对照组,并发症总发生率及术后24 h白细胞计数、C反应蛋白和白细胞介素-6水平均低于对照组(P<0.05)。结论腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石通过微创技术实现精准探查和取石,具有创伤小、取石彻底、术后恢复快等优点,并发症少且炎症反应轻。Objective To evaluate the safety and efficacy of dual endoscopic approaches(laparoscopy and choledochoscopy)for managing concomitant cholecystolithiasis and choledocholithiasis.Methods A total of 92 patients with cholecystolithiasis complicated with choledocholithiasis admitted to the Fourth Division Hospital of Xinjiang Production and Construction Corps from January to December 2023 were selected and divided into observation group(n=46)and control group(n=46)according to random number table method.The control group was treated with laparotomy,and the observation group was treated with laparoscopy combined with choledochoscopy.The surgical indexes,complications and inflammatory factors were compared between the two groups.Results The operation time,postoperative ambulation time,first anal exhaust time and hospitalization time in the observation group were shorter than those in the control group,the intraoperative blood loss was less than that in the control group,the total incidence of complications and the levels of white blood cell count,C reactive protein and interleukin-6 at 24 h after operation were lower than those in the control group(P<0.05).Conclusions Laparoscopy combined with choledochoscopy in the treatment of cholecystolithiasis complicated with choledocholithiasis can achieve accurate exploration and stone removal through minimally invasive techniques.It has the advantages of small trauma,complete stone removal,rapid postoperative recovery,few complications and mild inflammatory reaction.

关 键 词：胆囊结石 胆总管结石 腹腔镜手术 胆道镜手术 并发症 C反应蛋白 

分 类 号：R657[医药卫生—外科学]