摘要
目的 分析胆总管探查取石术(LCBDE)联合腹腔镜胆囊切除术(LC)方案与开腹胆管取石手术方案干预胆囊结石合并胆总管结石病例的效果。方法 对72例手术干预的胆囊结石伴胆总管结石病例进行治疗效果的观察,其中36例为LCBDE+LC方案(观察组),其余的36例为开腹胆管取石手术方案(对照组),对比两组患者的手术成功率、结石残留率、术中血液流失量、住院天数、住院花费、切口长度及并发症率。结果 两组的手术成功率、结石残留率以及并发症发生率比较差异均无统计学意义(P>0.05)。观察组患者的术中血液流失量、住院天数均显著少于对照组,切口长度短于对照组,住院花费多于对照组(P均<0.05)。结论 LCBDE+LC方案干预胆囊结石伴胆总管结石可以取得更高的手术疗效及安全性,利于帮助患者加速康复,控制术中血液流失,且切口美观度高。
Objective To compare the efficacy of laparoscopic common bile duct exploration(LCBDE)combined with laparoscopic cholecystectomy(LC)versus open common bile duct exploration(OCBDE)in the treatment of patients with cholecystolithiasis and concomitant choledocholithiasis.Methods The therapeutic outcomes of 72 patients undergoing surgical intervention for cholecystolithiasis with choledocholithiasis were retrospectively analyzed.Thirty-six patients were treated with LCBDE combined with LC(observation group),and another 36 patients underwent OCBDE(control group).Surgical success rate,residual stone rate,intraoperative blood loss,length of hospital stay,hospitalization cost,incision length,and postoperative complication rate were compared between the two groups.Results There were no statistically significant differences between the two groups in terms of surgical success rate,residual stone rate,and incidence of complications(P>0.05).The observation group had significantly less intraoperative blood loss and shorter hospital stay compared to the control group,with shorter incision length and higher hospitalization costs than the control group(P<0.05).Conclusion The LCBDE combined with LC regimenfor cholecystolithiasis with choledocholithiasis achieves comparable efficacy and safety to the open approach,with advantages including reduced intraoperative blood loss,faster postoperative recovery,and improved cosmetic outcomes due to smaller incisions.
作者
薛飞
Xue Fei(Department of General Surgery,Xincai County People's Hospital,Zhumadian 463500,Henan,China)
关键词
胆总管探查取石术
腹腔镜胆囊切除术
胆囊结石
胆总管结石
Laparoscopic common bile duct exploration
Laparoscopic cholecystectomy
Cholelithiasis
Choledocholithiasis
