腹腔镜联合胆道镜胆管切开取石术在治疗肝内外胆管结石中的微创治疗价值

Laparoscope Combined with Choledochoscope in Common Bile Duct Lithotomy Value of Minimally Invasive Treatment in the Treatment of Extrahepatic Bile Duct Stones

目的:探讨分析腹腔镜联合胆道镜胆管切开取石术在治疗肝内外胆管结石中的微创治疗价值。方法:选取2012年6月-2013年6月本院收治的40例肝内外胆管结石患者(部分患者同时合并胆囊结石),按随机数字表法分为观察组和对照组,每组各20例。观察组患者给予腹腔镜联合胆道镜胆管切开取石术治疗,对照组患者给予传统开腹手术方式治疗。观察比较两组患者的手术操作时间、术中出血量、住院时间、并发症发生率、残石率。结果:观察组的手术操作时间为(98.0±9.5)min,术中出血量为(90.3±9.8)mL,住院时间为(9.5±4.3)d,并发症发生率为5%,残石率为10%。观察组上述指标均明显优于对照组,差异均有统计学意义(P<0.05)。结论:腹腔镜联合胆道镜胆管切开取石术在治疗肝内外胆管结石中的微创治疗价值巨大,手术操作时间短、术中出血量少、住院时间短、并发症发生率低、残石率低,值得推广应用。

Objective： To investigate the analysis of laparoscope combined with choledochoscope in common bile duct lithotomy value of minimally invasive treatment in the treatment of extrahepatic bile duct stones. Method： 40 cases of hepatolithiasis （ part of the patients with gallbladder stones ） in our hospital from June 2012 to June 2013 were selected, and were divided into the observation group and the control group according to random number table method, 20 patients in each group. The observation group were treated with laparoscopic choledochotomy treatment, the control group received the treatment of the traditional open operation mode. The operation time, bleeding volume during operation, hospitalization time, complications, residual stone rate of two groups were observed. Result： In the observation group, the operation time were （ 98.0 ± 9.5 ） min,＂ intraoperative blood loss were （ 90.3 ± 9.8 ） mL, hospitalization time were （ 9.5 ± 4.3 ） d,complications were 5%, residual stone rate were 10%. The above indicators of the observation group were better than the control group, the differences were statistical significance （ P〈0.05 ） . Conclusion： Laparoscopy combined with choledochoscopy for bile duct incision and minimally invasive treatment of stone surgery in the treatment of extrahepatic bile duct stones of great value, short operation time, less bleeding, shorter hospital stay, the drainage time is short, low complication rate, low residual stone rate, it is worthy of popularization and application.