123例胆总管结石的微创外科治疗效果分析

Analysing of 123 cases of bravery manager of minimally invasive surgical treatment effect

目的分析胆总管结石的微创外科治疗效果。方法本研究选择2008年1月～2010年1月在我院诊断为胆总管结石的患者123例,随机平均分为3组:腹腔镜下胆囊切除术+十二指肠乳头括约肌切开取石术组(LC+EST组)、LC+腹腔镜联合纤维胆管镜胆总管切开探查术组(LC+LCBDE组)和LC+十二指肠镜下乳头气囊状扩张术(EPBD)组(LC+EPBD组),比较3种微创方法治疗胆总管结石的临床效果。结果 3组患者手术的成功率、结石残留、并发症等方面差异无统计学意义,P>0.05。LC+LCBDE组的手术时间最短,和LC+EST组差异有统计学意义,P<0.01。LC+EPBD组的住院时间最短,LC+EPBD组和LC+LCBDE组、LC+EPBD组和LC+EST组,差异有统计学意义,P<0.01。LC+EST组结石复发率最高,与LC+LCBDE组和LC+EPBD组比较,差异均有统计学意义,P<0.01。结论 3种微创方法均是治疗胆总管结石的成熟方法,可根据患者的实际情况和微创手术的适应证,选择合适的微创方法。

Objective To analyse the bravery manager of minimally invasive surgical treatment effect. Methods Choosing from January 2008 to January 2010 in our hospital diagnosis for bravery manager of the patients 123 eases were randomly aver- age into three groups ： laparoscopic cholecystectomy ＋ duodenal nipple sphincter take stone cut operation group （ LC ＋ EST group ）, LC ＋ laparoscopic joint fiber biliary mirror cut bravery manager exploration technique group （ LC ＋ LCBDE group） and LC ＋ duode- nal microscopically nipple balloon dilatation shape （EPBD） group （LC ＋ EPBD group）, more three kinds of minimally invasive treatment method of bravery manager stone clinical effect. Results The three groups of patients, surgical success rate, the stone residue, complications were not significant differences, P 〉 0. 05. LC ＋ LCBDE group of operation time is the shortest, and LC ＋ EST group has obvious difference statistical significance, P 〈 0. 01. LC ＋ EPBD group of the length of time the shortest, LC ＋ EPBD group and the LC ＋ LCBDE group, the LC ＋ EPBD group and the LC ＋ EST group, has the obvious difference were statisti- cally significant, P 〈 0. 01. LC ＋ EST group stone highest recurrence, and LC ＋ LCBDE group and the LC ＋ EPBD group com- pared with obvious difference were statistically significant ,P 〈 0.01. Conclusion Three methods are minimally invasive treatment is bravery manager mature method, can according to the patient＇s actual conditions and minimally invasive surgical indications, choose appropriate minimally invasive method.