腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的效果观察

Effect of laparoscopy combined with choledochoscope in the treatment of cholecystolithiasis complicated with choledocholithiasis

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效果.方法 选取忻州市人民医院2016年4月至2018年6月收治的90例胆囊结石合并胆总管结石患者,根据随机数表法分为观察组和对照组,每组45例.对照组采用开腹手术治疗,观察组采用腹腔镜联合胆道镜治疗,观察比较两组手术相关指标、肝功能指标及并发症发生情况.结果 与对照组比较,观察组术中出血量较少,肛门排气时间、手术时间及住院时间较短,差异有统计学意义(P<0.05);观察组术后并发症发生率低于对照组,差异有统计学意义(P<0.05).术后24 h时,两组天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBIL)水平均高于术前,且观察组AST、ALT、TBIL水平低于对照组,差异有统计学意义(P<0.05).结论 腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石患者,可减少其术中出血量、肝功能损伤及并发症发生情况,缩短术后恢复时间.

Objective To investigate the effects of laparoscopy combined with choledochoscope on patients with cholecystolithiasis and choledocholithiasis.Methods A total of 90 patients with cholecystolithiasis combined with choledocholithiasis hospitalized in Xinzhou People's Hospital from April 2016 to June 2018 were selected and divided into observation group and control group by the random number table method,with 45 cases in each group.Patients in control group were treated by open surgery,while patients in observation group were treated by laparoscopy combined with choledochoscopy.The surgical indicators,liver function indicators and complications of the two groups were compared.Results Compared with control group,the observation group had less intraoperative blood loss,shorter anal exhaust time,operation time and hospital stay,and the difference between the two groups was statistically significant(P<0.05).The postoperative complication rate in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).The levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT)and total bilirubin(TBIL)24 hours after surgery were higher than those before surgery in both groups,but the levels of AST,ALT and TBIL in observation group were lower than those in control group,with statistically significant differences(P<0.05).Conclusions Laparoscopy combined with choledochoscopy is effective in alleviating intraoperative hemorrhage and liver damage,reducing complications and shortening the postoperative recovery time for patients with cholecystolithiasis and choledocholithiasis.