腹腔镜下胆道镜联合微爆破碎石术治疗肝胆管结石病临床效果观察

A preliminary evaluation the efficacy of laparoscope combined choledochoscope shockwave lithotripsy for the treatment of hepatobiliary calculi

目的探讨腹腔镜下胆道镜联合微爆破碎石术治疗肝胆管结石的临床效果。方法回顾性2011年2月至2012年2月手术治疗肝胆管结石病的患者62例的临床资料,其中腹腔镜下胆道镜联合微爆破碎石术(联合组)28例,传统开腹手术组34例,观察两组的临床效果。结果两组碎石成功率均为100%,结石取尽率比较差异无统计学意义(P>0.05),但在手术时间、术中出血、胃肠功能恢复时间及住院时间方面,微创组明显优于开腹组;术后消化道出血和切口感染发生率低于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜下胆道镜联合微爆破碎石术治疗肝胆管结石病,具有微创、安全、有效的优点。

Objective To explore the differences between laparoscope combined with choledochoscope shockwave lithotripsy and open operation in the treatment of intrahepatobiliary and extrahepatobiliary calculi. Methods The clinical data of 62 consecutive patients with intrahepatobiliary and extrahepatobiliary calculi who received treatment from February 2011 to February 2012 were retro- spectively analyzed. Laparoscope combined with Choledochoscope shockwave lithotripsy was applied to 28 patients （ combined group）, whereas open operation was applied to the rest 34 patients （operation group）. Hospital stay and complications have been analyzed. Re- suits The lithotripsy successful ratio of two groups was 100%. The hepatobiliary calculi＇s cleaning out ratio of two group was not statis- tically significant（ P 〉 O. 05 ）. However the operation time, intraoperative blood loss, recovery of gastroentestine, hospital stay of the pa- tients who were treated by combined group were much shorter than who were treated by operation group. Gastrointestinal bleeding and wound infection have rarely happened in combine group,The difference was statistically significant （ P 〈 0.05）. Conclusion Laparo- scope combined with choledochoscope shockwave lithotripsy is proved safe and worth promoting.