腹腔镜治疗肝内胆管结石的临床观察

Clinical observation of treatment of hepatolithiasis with laparoscopy

目的探讨腹腔镜联合胆道镜治疗肝内胆管结石的临床应用价值。方法根据4项病例筛选标准,将2002年1月￣2005年3月42例肝内胆管结石患者,随机分为腹腔镜组与开腹手术组,比较观察两组的手术时间、残石率、术中出血量和肛门排气时间、术后并发症等。结果腹腔镜组20例,开腹组22例。腹腔镜组较开腹手术组术中出血量少,肛门排气更快,手术并发症更少。结论腹腔镜治疗肝内胆管结石体现了微创外科技术的优越性,在选择合适的病例的前提下是安全可行的,值得推广应用。

[Objective] To explore the clinical significance of laparoscopy combined with choledochoscopy in treatment of hepatolirhiasis. [Methods] According to 4 criteria, 42 patients with hepatolithiasis from January to February 2005 were operated. The patients were randomly divided into two groups： open operation group and laparoscopy group. Their data were recorded and studied, including operation time, vesidual stones, operative blood loss, post operation complications etc. [Results] There were 20 patients and 22 patients in laparoscopy group and open operation group. Compared with open operation group, aparoscopy group is less in the total quantity of operation blood loss, the recovery time of bowel function and post operation conplictions. [Conclusions] Laparoscopy in treatment of hepatolithiasis embody the value of minimally invasive technique, and it is safe and feasible in appropriate cases, so we advocate it.