摘要
目的:探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床效果。方法:选取胆囊结石合并胆总管结石患者160例,随机分为对照组与观察组,每组各80例。两组患者年龄、性别、病程、胆总管直径、临床表现及并发疾病等方面差异均无统计学意义(P>0.05)。观察组行腹腔镜联合胆道镜治疗,对照组采用开腹手术治疗,对比两组患者术中出血量、住院时间、手术时间、肠排气时间、镇痛药使用率、术后感染率、总并发症发生率等指标。结果:与对照组相比,观察组患者住院时间少、手术时间短、术中出血量小、肠排气时间缩短、镇痛药使用率低、术后感染率低、总并发症发生率低,各项指标明显优于对照组,差异有统计学意义(P<0.05)。结论:应用腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石疗效确切、费用低,是安全、可行的。病例选择得当,术者具备丰富的胆道外科手术经验及熟练的纤维胆道镜操作技术,腹腔镜下联合纤维胆道镜经胆囊管胆总管探查取石术是创伤小、康复快的术式,值得临床推广应用。
Objective：To study the effect of laparoscopy combined choledochoscopy in the treatment of cholecystolithiasis and choledocholithiasis. Methods：One hundred and sixty patients with cholecystolithiasis and choledocholithiasis were randomly divided in- to control group （ n = 80） and observation group （ n = 80）. Patients in each group had no obvious difference in age, gender, course of the disease, diameter of common bile duct, clinical presentation and concurrent diseases （P 〉 0.05 ）. Observation group were treated with laparoscopy combined choledochoscopy and control group were treated with open operation. The intraoperative blood loss, hospital stay, operative time, intestinal exhaust time, analgesic usage and postoperative infection rate, total incidence of complications were compared between the two groups. Results： Compared with the control group, the patients of the observation group had shorter hospital stay, shorter operation time,less intraoperative blood loss and intestinal exhaust time,lower postoperative analgesic utilization rate,infection rate and total complication rate, and every index was superior to the control group （P 〈 O. 05 ）. Conclusions： The laparoscopy combined choledo- choscopy in the treatment of cholecystolithiasis and choledocholithiasis is safe, feasible, mini-invasive and worthy of popularization and application,with the advantages of good curative effect, low cost, and quick recovery for chosen patients when surgeons are experienced in bihary tract surgical procedures and choledochofiberscopy.
出处
《腹腔镜外科杂志》
2015年第7期539-542,共4页
Journal of Laparoscopic Surgery
