硬镜与鞘管在腹腔镜胆总管切开取石术中的应用价值

Clinical value of rigid choledochoscope and sheath in laparoscopic choledocholithotomy WEN

目的 探讨硬镜与鞘管在腹腔镜胆总管切开取石手术中的应用价值.方法 对比分析本院2003年5月至2006年6月进行的104例腹腔镜胆总管切开取石术中使用硬镜与鞘管的情况.观察组53例,应用硬镜与鞘管;对照组51例,没有使用硬镜与鞘管.对比两组的临床治疗效果.结果 全部病例均没有胆道大出血、胆漏等严重并发症.两组操作时间、引出量差异有统计学意义(P<001),而出血次数、灌注量和结石残留率差异没有统计学意义(P>0.05).结论 硬镜与鞘管在腹腔镜胆总管切开取石手术中能加快取石速度、缩短操作时间、减少结石和灌注液体进入腹腔后遗留与污染的机会,没有增加结石残留率,临床应用价值较大.

Objective To evaluate the clinical value of rigid choledochoscope and sheath in the laparoscopic choledocholithotomy. Methods Clinical data of 104 cases receiving laparoscopic choledocholithotomy from May 2003 to June 2006 were analyzed retrospectively. Fifty-three cases of trial group underwent choledocholithotomy with rigid choledochoscope and sheath,and 51 cases of control group with cholangioscope. Clinical efficacy was compared between two groups.Results All the cases were cured. No complications,such as bile leakage and/or hemorrhage,occurred. There was no significant difference in hemorrhage,perfusion volume and residually rate of stones between two groups(P>0.05),while the operation time and drainage volume were significantly different between two groups(P<0.01). Conclusions Rigid choledochoscope and sheath is valuable to the laparoscopic choledocholithotomy and choledochoscopy,which can shorten the operation time,avoid blindness during insetting cholangioscope and decrease the side effect.