腹腔镜联合一次性胆道镜在经胆囊管途径行胆总管探查术取石中的临床应用  

Clinical Application of Laparoscopic Combined with Disposable Cholangioscopy in the Exploration of the Common Bile Duct through the Cystic Duct for Stone Removal

作　　者：李强 赵俊 杨建方 王俊 张小斌 LI Qiang;ZHAO Jun;YANG Jianfang;WANG Jun;ZHANG Xiaobin(Department of Hepatobiliary Surgery,the First People's Hospital of Jingdezhen,Jingdezhen 333000,China;不详)

机构地区：[1]景德镇市第一人民医院肝胆外科,江西景德镇333000

出　　处：《中国医学创新》2025年第12期42-46,共5页Medical Innovation of China

基　　金：景德镇市科技计划项目(2021ISFZC011)。

摘　　要：目的:探讨腹腔镜联合一次性胆道镜经胆囊管途径行胆总管探查术(LTCBDE)治疗胆囊结石合并胆总管结石的临床应用。方法:回顾分析景德镇市第一人民医院肝胆外科2023年10月—2024年4月收治的胆囊结石合并胆总管结石患者共计60例。根据研究对象所接受手术方案的不同将上述研究对象划分为试验组(n=25)及常规手术组(n=35)。常规手术组研究对象接受腹腔镜胆囊切除术(LC)+腹腔镜胆总管探查(LCBDE)+T管引流术;试验组患者接受LTCBDE。记录并比较两组研究对象手术时间、术中出血量、总住院时间、术后淀粉酶水平、总胆红素水平、手术相关并发症发生率。结果:试验组研究对象的手术时间、总住院时间均短于常规手术组(P<0.05);两组研究对象术后1 d淀粉酶(AMS)水平及总胆红素(TBIL)水平的差异均无统计学意义(P>0.05);术后3 d,两组上述检测水平均出现了明显下降,且试验组均低于常规手术组(P<0.05);试验组患者的术后并发症发生率显著低于常规手术组(P<0.05)。结论:LTCBDE具有恢复快、并发症少的优点,故拥有较高的临床应用价值。Objective:To explore the clinical application of laparoscopic transcystic common bile duct exploration(LTCBDE)in the treatment of gallbladder stones combined with choledocholithiasis.Method:A total of 60 patients with gallbladder stones and choledocholithiasis admitted to Department of Hepatobiliary Surgery of the First People's Hospital of Jingdezhen were retrospectively analyzed between October 2023 and April 2024.According to different surgical methods,they were divided into experimental group(n=25,LTCBDE)and routine surgery group[n=35,laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)+T-tube drainage].The operation time,intraoperative blood loss,total length of hospital stay,levels of amylase and total bilirubin,and incidence of surgery-related complications in the two groups were recorded and compared.Result:The operation time and total length of hospital stay in experimental group were shorter than those in routine surgery group(P<0.05).At 1 d after surgery,there were no significant differences in amylase(AMS)or total bilirubin(TBIL)between the two groups(P>0.05).At 3 days after surgery,the above-mentioned detection levels were significantly decreased in both groups,those were lower in experimental group than those in routine surgery group(P<0.05).The incidence of postoperative complications in experimental group was significantly lower than that in routine surgery group(P<0.05).Conclusion:LTCBDE has advantages such as rapid recovery and fewer complications,with high clinical application value.

关 键 词：胆总管结石 胆囊结石 经胆囊管胆道镜检查 

分 类 号：R657.4[医药卫生—外科学]