纤维胆道镜联合腹腔镜行胆管探查取石加一期缝合术疗效分析

The clinical effects of laparoscopic common bile duct exploration and primary suture combined with choledo-choscopy on cholelithiasis

目的探讨纤维胆道镜联合腹腔镜胆管探查取石加一期缝合术（LBEPS）与腹腔镜胆管探查取石加T管引流术（LCHTD）的临床疗效差异。方法选取胆总管结石患者101例，随机按照手术方法不同分为两组：LCHTD治疗组56例，纤维胆道镜联合LBEPS治疗组45例，比较两组疗效。结果纤维胆道镜联合LBEPS组与LCHTD组手术时间差异无统计学意义（P〉0．05）；纤维胆道镜联合LBEPS组术中出血量、术后消化功能恢复时间、平均住院时间优于LCHTD组（均P〈0．05）；LBEPS组并发症及胆管镜取石再治疗均少于LCHTD组（P〈0．05）。结论纤维胆道镜联合LBEPS与LCHTD相比，具有创伤小、术后恢复快、并发症少等优点，具有一定的临床推广价值。

Objective To explore the clinical effects of laparoscopic common bile duct exploration and primary suture combined with choledoehoscopy （LBEPS） and laparoscopic common bile and duct exploration T-tube drainage（LCHTD） on cholelithiasis. Methods 101 cholelithiasis patients were selected and, grouped by the operation methods. 56 cases were treated with LCHTD,while 45 cases were treated with LBEPS. The operation time, blood lose, and postoperative digest function recovery time were ampared betreen two groups. Results The operation time betreen the two groups has no significant difference（ P 〉 0.05 ）, while the blood lose, postoperative digest function recovery time in LBEPS group were better than the LCHTD group（ all P 〈 0.05 ） , the differences were statistically significant. Meanwhile the LBEPS group had a less complication and re-treatment rate than those of the LCHTD group （ P 〈 0.05 ）. Conclusion Compared with LCHTD, LBEPS had smaller trauma, less operation complications and faster postoperative digest recovery time, worthy of clinical promotion.