腹腔镜与开腹胆总管切开取石的前瞻性临床对比研究  

Laparoscopic and open treatment for choledocholithiasis:a prospective clinical comparative study

作　　者：周晓初[1] 熊沛[1] 付江华[1] 周汉新[1] 彭毅[1] 

机构地区：[1]北京大学深圳医院腔镜外科中心,深圳518036

出　　处：《中国微创外科杂志》2002年第6期390-391,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　比较腹腔镜胆总管切开取石与开腹手术的临床效果。　方法　比较 2 9例腹腔镜胆总管切开取石和 35例开腹胆总管切开取石的临床资料 ,比较指标为手术时间、胃肠道恢复时间、输液量、住院时间、住院总费用及术后并发症等。　结果　两组在年龄、性别、病种等无明显差异。腹腔镜组结石清除率为96 6 % (2 8/2 9) ,开腹手术组为 91 4% (32 /35 ) (χ2 =0 71,P =0 399) ;手术时间开腹组为 (145 8± 2 7 1)分钟 ,腹腔镜组为 (178 3± 32 4)分钟 (t=4 2 7,P <0 0 1) ;胃肠道恢复时间开腹组为 (5 8 2± 4 9)小时 ,腹腔镜组为(2 0 8± 2 9)小时 (t=37 8,P <0 0 1) ;术后住院时间开腹组 (16 5± 3 8)天 ,腹腔镜组 (6 2± 1 8)天 (t=14 2 2 ,P <0 0 1) ;住院总费用开腹组为 (780 0± 2 90 0 )元 ,腹腔镜组为 (85 0 0± 130 0 )元 (t=1 2 8,P >0 0 5 ) ;术后并发症两组分别为 5例和 0例。　结论　腹腔镜胆总管切开取石是一种安全、可靠的方法 ,此方法优于开腹方法。Objective To compare the therapeutic results of laparoscopic and open treatment for choledocholithiasis. Methods A prospective comparison was conducted between 29 cases of laparoscopic choledocholithotomy and 35 cases of open choledocholithotomy in terms of stone removal,operative time,hospitalization day,hospitalization cost and postoperative complications. Results Stone removal was achieved in 28/29 patients by a laparoscopic approach and in 32/35 patients by a open approach( χ 2=0 71, P =0 399);average operative time was (178 3±32 4) min in laparoscopic approach and (145 8±27 1)min in open approach( t =4 27, P =0 01);the patients in laparoscopic procedures had flatus in (20 8±2 9) hour and those in open procedures did in (58 2±4 9) hours( t =37 8, P <0 01);the average hospitalization time after surgery was (6 2±1 8) days and (16 5±3 8) days( t =14 22, P <0 01)respectively;the average operative cost was $(8500±1300) in laparoscopic approach and $(7800±2900) in open approach( t =1 28, P >0 05);no major complication was found in laparoscopic approach. Conclusions Laparoscopic choledocholithotomy is safe and effective and it is superier to open treatment.

关 键 词：腹腔镜 胆总管切开取石 胆总管结石 临床研究 

分 类 号：R657.4[医药卫生—外科学]