腹腔镜胆道镜联合微创保胆取石术的临床疗效及安全性探讨

Clinical Efficacy and Safety of Minimally Invasive Cholecystolithotomy with Gallbladder Preserved by Laparoscope Combined with Cholangioscope

目的:观察腹腔镜联合胆道镜微创保胆取石术治疗胆囊结石的临床疗效及安全性。方法:选取我院自2009年3月至2012年5月收治的115例胆囊结石患者作为研究对象,在患者知情同意基础上按照随机数字表法随机分为观察组60例与对照组55例,观察组采用腹腔镜联合胆道镜微创保胆取石术,对照组采用腹腔镜胆囊切除术,比较两组患者的手术疗效及并发症情况。结果:①观察组手术时间、术中出血量、胃肠功能恢复时间及住院时间较对照组均明显减少(P<0.01),具有统计学意义。②观察组术后并发症2例,发生率为3.3%;对照组术后并发症9例,发生率为16.4%。观察组术后并发症发生率明显低于对照组(X2=12.025,P<0.01),具有统计学意义。结论:腹腔镜联合胆道镜微创保胆取石术治疗胆囊结石具有创伤小、术后恢复快、并发症少等优点,值得临床推广应用。

Objective： To observe the clinical efficacy and safety of minimally invasive cholecystolithotomy with gallbladder preserved by laparoscope combined with cholangioscope in treating gallstone. Method： 115 patients with gallstone treated in our hospital from March 2009 to May 2012 were selected as research objects and randomly divided into two groups based on patients＇ informed consent according to randomly digital table, the observation group with 60 cases and the control group with 55 cases. The observation group were applied minimally invasive cholecystolithotomy with gallbladder preserved by laparoscope combined with choledoehoscope, and the control group received laparoscopic choleeystectomy. The operation efficacy and complications of two groups were compared. Result： ①The operation time, intraoperative bleeding amount, recovery time of gastrointestinal function and hospital stays of the observation group reduced evidently compared with control group（ P〈0.01 ） ,which had statistical significance. ②In the observation group, there were two cases with complications, and the incidence rate was 3.3%. And in the control group, there were 9 cases with complications after operation, and the incidence rate was 16.4%. Complication rate of the observation group after operation was lower evidently than that of the control group （X^2= 12. 025 ,P〈0.01 ）, which had statistical significance. Conclusion：Minimally invasive cholecystolithotomy with gallbladder preserved by laparoscope combined with cholangioscope in treating gallstone has the advantages of minimal trauma, rapid recovery after operation and fewer complications, which is worthy of promotion and application in clinical practice.