腹腔镜胆总管探查取石治疗肝内胆管结石疗效分析

Clinical observation on laparoscopic common bile duct exploration in the treatment of intrahepatic duct stone

目的探讨腹腔镜胆总管探查(LCBDE)治疗肝内胆管结石的临床疗效。方法将72例患者分为LCBDE组(36例)和开腹手术组(36例),后者为对照组。2组平均年龄分别为(62.4±16.9)岁和(61.2±16.4)岁。研究并记录2组患者手术时间、术后可以进食时间、住院天数、ICU入住率、医疗费用以及术后并发症等基本资料。结果 LCBDE组和对照组患者的平均年龄、性别构成、入院时间与手术时间间隔等一般临床资料差异无统计学意义(P>0.05)。2组在住院天数方面差异无统计学意义(P>0.05);LCBDE组的手术时间、术后ICU入住率明显少于或低于对照组,2组数据相比,差异皆有统计学意义(P<0.01);LCBDE组患者术后可以进食时间、医疗费用都比对照组要短或低,2组数据相比差异有统计学意义(P<0.05)。对照组更容易产生并发症。结论 LCBDE治疗肝内胆管结石无论是治疗效果还是在降低医疗花费方面都要比传统开腹手术有优势,值得临床进一步推广。

[ Objective] To study the efficacy of laparoscopic common bile duct exploration （LCBDE） in the treatment of intrahepatic duct stone. [ Methods ] 72 patients with intrahepatie duct stone were divided into the LCBDE group and the open surgery group （the control group） , 36 cases in each group. The average age of two groups was （62.4 ±16.9 ） years old and （61.2 ±16.4） years old respectively. The data of operation time, oral feeding time after operation, hospital days, rate of/CU stay, hospitalization cost and postoperative complications were analyzed in two groups. [ Results] There was no significant difference in the general clinical data between two groups, which included average age, gender composition, admission time and operation interval （ P 〉 0.05 ）. The difference in hospital days between two groups was not significant （ P 〉 0.05 ）. The operation duration and rate of ICU stay after operation in the LCBDE group were significantly lower than those in the control group （ P 〈 0.01 ）. The oral feeding time after operation and hospitalization cost in the LCBDE group were significantly lower than those in the control group （P 〈0.05）. The incidence rate of complications was higher in the control group. [ Conclusion] LCBDE is better than traditional open surgery in the treatment of intrahepatic duct stone, not only in efficacy but also in hospitalization cost, and it＇s worthy of clinic application.