胆囊并胆总管结石不同手术的近远期疗效观察

Observing Short and Long-term Effect of Cholelithiasis and Choledocholithiasis Treated by Different Operation

目的:评价不同手术治疗胆囊结石并胆总管结石近、远期治疗效果。方法:选择已确诊的330例胆囊并胆总管结石患者,随机分为开腹组(n=92),采用开腹胆囊切除联合胆总管切开取石+T管引流术;(EST+LC)组(n=110)采用EST+LC术式,(LC+LCBDE)组(n=128)采用LC+LCBDE术式,比较分析三组手术时间、术中失血量、术后肛门排气时间、手术成功率、住院时间和费用、术后近期和远期并发症发生率。结果:三组手术成功率差异无统计学意义(P>0.05),手术时间、术中失血量、术后肛门排气时间、住院时间、术后近期并发症发生率以开腹组最高,住院费用及术后远期并发症(EST+LC)组最高,差异均有统计学意义(P<0.05)。结论:治疗胆囊结石并胆总管结石根据实际情况,优选LC+LCBDE术式,慎用EST+LC术式,开腹手术作为辅助方案。

Objective：To evaluate short and long-term effect of cholelithiasis and choledocholithiasis treated by different operation.Methods：We selected 330 cases of patients confirmed cholelithiasis and choledocholithiasis.They were randomly divided into Open group（n=92）who were treated by open cholecystectomey and open choledocholithotomy T-tube drainage;（EST＋LC）group（n=110） who were treated by（EST＋LC）’s operation and（LC＋LCBDE） group（n=128） who were treated by（LC＋LCBDE）’s operation.The operation time,intraoperative blood loss,postoperative anal exhaust time,operation successful rate,hospitalization time and cost,incidence of short and long-term postoperative complications of three groups were comparativly analysised.Results：The operation successful rate of three groups had no significant difference（P〈0.05）.The operation time,intraoperative blood loss,postoperative anal exhaust time,duration of hospitalization,the rate of short-term postoperative complications of open group were the highest,the hospitalization cost and longterm postoperative complications of（EST＋LC）group were the highest,the differences were all statistically significant（all P〈0.05）.Conclusion：According to actual condition,the therapy of cholelithiasis and choledocholithiasis is preferably（LC＋LCBDE） operation method,is careful with（EST＋LC） operation method,Surgery Abdomen shoud be Auxiliary method.