三种不同术式治疗胆囊结石合并胆总管结石的临床研究

The clinical research of three different kinds of operation in the treatment of cholecystolithiasis and choledocholithiasis

目的:对比分析三种不同术式治疗胆囊结石合并胆总管结石的疗效。方法:将102例胆囊结石合并胆总管结石患者随机分为3组,A组行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)+胆总管探查术(laparoscopic common bile ductexploration,LCBDE);B组行传统开腹胆囊切除术(open cholecystectomy,OC)+胆总管探查术(open common bile duct explora-tion,OCBDE);C组行LC联合内镜下Oddi括约肌切开取石术(endoscopic sphincterotomy,EST)。对比分析3组患者的手术时间、术中出血量、术后疼痛程度、术后肠功能恢复时间、并发症发生率、术后恢复工作时间、术后T管拔除时间、住院时间等情况。结果:A组手术指标明显优于B、C两组。结论:腹腔镜胆囊切除联合胆总管探查术安全可行。

Objective：To compare the effectiveness of three different kinds of operation in the treatment of cholecystolithiasis and choledocholithiasis.Methods：One hundred and two patients with cholecystolithiasis choledocholithiasis were randomly divided into three groups,group A：laparoscopic cholecystectomy and common bile duct exploration（LC＋LCBDE）,group B：cholecystoctomy and common bile duct exploration under laparotomy（OC＋OCBDE）,group C：LC and endoscopic sphincterotomy（LC＋EST）.Then the operative time,blood loss,pain score,time for resumption of intestinal function,incidence of postoperative complications,the time for returning to work after surgery,duration of T-tube and the average time in hospital among 3 groups were compared.Results：Group A was significantly superior to group B and C.Conclusions：LC and LCBDE is safe and feasible.Furthermore,it is minimally invasive.