腹腔镜、胆道镜联合治疗胆总管结石的临床研究

Clinical research on the combined application of laparoscopy and choledochoscopy in treatment of choledocholith

目的:探讨腹腔镜胆道镜胆总管探查取石的可行性、安全性及适应证。方法:对比分析腹腔镜手术组(n=20)与开腹手术组(n=20例)胆总管探查取石术的手术时间、术中出血量、术后排气时间、住院天数、术后疼痛、并发症发生率等。结果:腹腔手术组与开腹手术组手术时间分别为(133.65±16.71)min、(89.8±11.02)min,术后止痛剂使用率分别为20%、85%,术后排气时间分别为(31.15±4.98)h、(56.65±13.45)h,住院时间分别为(8.55±2.11)d、(14.95±2.96)d。以上项目两组均有统计学差异(P<0.01);并发症发生率分别为10%、25%,无明显差异(P>0.05)。结论:腹腔镜联合胆道镜胆总管切开取石术安全可靠,手术创伤小,值得临床推广。

Objective：To evaluate the feasibility,safety,and indication of the combined application of laparoscopy and choledochoscopy in common bile duct exploration.Methods：The operative time,blood loss,venting time,hospitalization,postoperative pain and complications were compared between the laparoscopic procedure group（n=20）and open procedure group（n=20）.Results：The operative time,analgesic usage rate,venting time and hospitalization of the two groups were（133.65±16.71）min vs.（89.8±12.02）min,20% vs.85%,（31.15±4.98）h vs.（56.65±13.45）h,and（8.55±2.11）d vs.（14.95±2.96）d respectively,all of which had significant difference（P〈0.01）.Complication rate was 10% and 25% respectively,which had no significant difference（P〉0.05）.Conclusions：The combined application of laparoscopy and choledochoscopy in choledocholith is safe and effective with the advantage of less trauma,thus worth being widely used clinically.