三种腹腔镜胆道探查方式治疗肝外胆管结石的疗效比较

Three different methods of laparoscopic common bile duct exploration for extrahepatic bile duct stones

目的比较三种腹腔镜胆道探查方式治疗肝外胆管结石的临床疗效。方法将100例患者分为三组,A组13例,行腹腔镜胆囊切除术+经胆囊管胆道探查;B组74例,行腹腔镜胆囊切除术加胆总管切开探查加胆管一期缝合;C组13例,行腹腔镜胆囊切除术加胆总管切开探查加T管引流。结果 1与C组相比,A组和B组的手术时间、腹腔引流时间、术后住院时间、恢复正常生活时间更短,差异具显著性(P<0.05);2三组患者在并发症及远期疗效方面并无明显差异(P>0.05)。结论三种微创手术方式有各自适应证,应根据患者情况灵活选择。

Objective To compare the efficacy and safety of three different methods of laparoscopic common bile duct exploration. Method 100 cases of patients with LCBDE were divided into three groups,Group A：13 patients were treated with laparoscopic transcystic common bile duct exploration; Group B： 74 patients were treated with laparoscopic common bile duct exploration followed by primary duct closure; Group C： 13 patients were treated with laparoscopic common bile duct exploration and T tube drainage. Result ①Compared with group C,group A and group B had significantly shorter operative time,shorter postoperative hospital stay,shorter peritoneal drainage time,lower hospital costs,and earlier return to work（ P〈0. 05）.②No significant differences in complications and long-term results of 3 groups（ P 0. 05）. Conclusion 3 kinds of minimally invasive operation mode has its own indications,clinical should be selected according to the conditions of patients.