胆道镜结合小切口对胆总管结石治疗的效果分析

New method on the treatment of choledochoscope through mini-incision on the choledocholithiasis

目的探讨胆道镜结合小切口手术对胆总管结石治疗的效果。方法筛选60例合适的胆总管结石患者,对其采用胆道镜结合小切口的方法进行手术,统计手术成功率、并发症发生率;随机选取我院之前采用传统开腹手术的60例患者,对比两种方法治疗效果和费用。结果与对照组相比,实验组手术成功率达到100%,平均住院时间(9.5±2.5)d,短于对照组时间(13.0±3.5)d,平均切口长度也较短,并发症发生例数优于对照组,术中出血量和肛门排气时间均小于对照组,差异具有统计学意义(P<0.05)。结论胆道镜结合小切口手术是介于传统手术和腹腔镜手术的新式微创手术,在微创的前提下兼备开腹手术直视方便的优势,既适合于择期手术,又适合于急诊手术,无需特殊手术设备,便于普及和推广,开辟了一条安全、方便、实用、微创的较好途径。

Objective To analyze the new method on the treatment of choledochoscope through mini-incision on the choledocholithiasis and explore the clinical effect of choledocholithiasis. Methods A total of 60 cases of choledo- cholithiasis were operated in the choledochoscope through mini-incision and the success rate and complication rate were analyzed in statistics. 60 cases of regular laparotomy operation were chosen and the clinical effect and cost be- tween the two groups were compared. Results The operation success rate of the experimental group was 100%. The av- erage in-patient time of the experimental group （9.5＋2.5）d was shorter than that of the control group （13.0±3.5）d, and the average length of the incision was also shorter. The complication rate of the experimental group was better that of the control group. The amount of bleeding and evacuation time of the experimental group were lower than those of the control group and the difference were significant（P 〈 0.05 ）. Conclusion Choledochoscope through mini-incision oper- ation is a new method of minimally invasive surgery between the regular operation of laparotomy and laparoscopic surgery, on the basis of minimally invasive, the operation takes the advantage of direct inspection of laparotomy, which is used widely in the emergency operation and the selective operation. The operation need no special operation equip- ment and is apt at popularizing and spreading, which provides a safe, convenient, practical and minimally invasive method.