LC联合腹腔镜经胆囊管探查取石术治疗胆囊结石合并胆总管结石的效果分析

Analysis of the Effect of LC combined with Laparoscopic Exploration and Lithotomy Through Gallbladder Duct in the Treatment of Gallstone and Choledocholithiasis

目的探讨腹腔镜胆囊切除术(LC)联合腹腔镜经胆囊管探查取石术(LTDBDE)治疗胆囊结石合并胆总管结石的效果。方法将广东省深圳市龙岗中心医院2019年2月-2020年4月收治的100例胆囊结石合并胆总管结石患者按照随机数字表法分为对照组50例,给予LC联合胆总管切开探查取石治疗,观察组50例给予LC联合腹腔镜经胆囊管探查取石术治疗,观察两组治疗效果、围手术期状况、胃肠症状与结石清除情况及并发症。结果观察组总有效率(96.00%)与对照组(94.00%)对比差异无统计学意义(P>0.05);观察组术中出血量少于对照组,肛门排气时间、手术时间、引流管留置时间及住院时间均短于对照组(P<0.05);观察组GSRS分值低于对照组(P<0.05),结石清除率(96.00%)与对照组(94.00%)对比无统计学意义(P>0.05);观察组并发症发生率(4.00%)低于对照组(16.00%)(P<0.05)。结论LC联合腹腔镜经胆囊管探查取石术治疗胆囊结石合并胆总管结石可显著改善围手术期状况,减少胃肠症状,且能达到跟对照组一样的结石清除率,同时降低并发症的发生。

Objective To investigate the effect of laparoscopic cholecystectomy(LC)combined with laparoscopic cholecystectomy(ltdbde)in the treatment of gallstone and choledocholithiasis.Methods 100 patients with gallstone and choledocholithiasis were divided into control group by random digital table method from February 2019 to April 2020.LC and common bile duct incision were given to 50 patients in observation group.50 cases in observation group were treated by LC combined with laparoscopic exploration and lithotomy through gallbladder duct.The therapeutic effect,perioperative condition and the therapeutic effect of the two groups were observed Gastrointestinal symptoms,stone clearance and complications.Results The total effective rate of the observation group(96.00%)was not statistically significant(P>0.05)compared with the control group(94.00%);The bleeding amount in the observation group was less than that of the control group,and the time of anal exhaust,operation time,drainage tube retention time and hospitalization time were shorter than that of the control group(P<0.05).The GSRS score of observation group was lower than that of control group(P<0.05),and the stone clearance rate(96.00%)was not statistically significant compared with that of control group(94.00%)(P>0.05).The incidence of complications in the observation group(4.00%)was lower than that of the control group(16.00%)(P<0.05).Conclusion LC combined with laparoscopic exploration and lithotripsy through gallbladder tube can significantly improve the perioperative condition and reduce gastrointestinal symptoms,and achieve the same stone clearance rate as the control group,and reduce the occurrence of complications.