浅议胆囊结石合并胆总管结石的微创治疗

Shallow discussion gallbladder stone with minimally invasive treatment of common bile duct calculi

目的分析临床上采用微创治疗胆囊结石合并胆总管结石的效果。方法抽取近一年在我院接受微创治疗胆囊结石合并胆总管结石的20例患者的病例,采用回顾性方法分析。将其随机分成甲、乙、丙3个小组,分别比较不同手术方法的优势,具体主要包括术后恢复时间、术后并发症、住院时间、术中出血量以及残留结石等。结果所有手术没有造成任何人员死亡,其中采用腹腔镜胆囊切除术以及十二指肠镜乳头括约肌切开取石术(LC+EST)方法治疗的患者在手术过程中的出血量要明显少于其它两个小组,而采用行腹腔镜胆囊切除术结合胆囊管道的探查(LC+LTCBDE)的患者在术后的恢复时间均都明显的早于其他的两个小组。但在术后并发症以及恢复时间等均无统计学意义。结论在微创治疗胆囊结石合并胆总管结石的过程之中,我们要结合患者的自身情况,合理的选择治疗的方法,从而达到最佳的治疗效果。

Objective To analyze the clinical use of minimally invasive treatment of gallstones and biliary stones effects. Methods 20 cases taken nearly a year in our hospital minimally invasive treatment of gallstones in patients with biliary stones cases, the use of a retrospective method to analyze. It randomly divided into A, B, C three groups were compared for the three groups of the advantages of different surgical methods, specifically including postoperative recovery time, postoperative complications, hospitalization time, intraoperative blood loss and residual calculi. Results All operations did not cause any deaths, which uses laparoscopic cholecystectomy and duodenoscopy sphincterotomy lithotripsy （LC ＋ EST） method of treatment of patients in the amount of bleeding during surgery was significantly less than the other two groups, while the use of laparoscopic cholecystectomy combined with cystic duct exploration （LC ＋ LTCBDE）of patients in the postoperative recovery times are significantly earlier than the other two groups. But in the post-operative complications and recovery time were not statistically significant. Conclusion Minimally invasive treatment of gallstones in the common bile duct stones in the process of consolidation, we have to combine the patient＇s own situation, a reasonable choice of treatment methods to achieve the best therapeutic effect.