腹腔镜与开腹手术治疗高龄胆总管结石的疗效比较

Effect of laparoscopic and abdominal surgery in treatment of elderly choledocholithiasis

目的探讨腹腔镜与开腹手术治疗高龄胆总管结石（CBDs）的临床治疗效果。方法回顾分析我院2006年1月～2012年12月收治的98例高龄患者，分别行OCHTD术48例（对照组）和LCBDE术50例（观察组），对两组患者的术中情况及术后情况、平均住院时间、住院费用及术后并发症发生率进行对比分析。结果所有患者均治愈出院，观察组和对照组在治疗过程中的治疗效果比较差异有统计学意义（P〈0．05）；观察组术中出血量、切口长度、术后镇痛例数、术后胃肠功能恢复时间、住院时间明显优于对照组。观察组并发症的发生率（6％）明显低于对照组（25％），差异具有统计学意义（P〈O．05）。结论在治疗高龄CBDs中LCBDE的疗效更为优越，更值得在基层医院推广。

Objective To observe and compare the efficacy of laparoscopic and abdominal surgery in treatment of el- derly choledocholithiasis. Methods Chose 98 cases of elderly patients with choledocholithiasis in the hospital from January 2006 to December 2012, which were divided into observation group （LCBDE）and control group（OCHTD）ac- cording to different surgery, 50 cases in the experimental group and 48 cases in the control group. Intraoperative and postoperative conditions, average length of stay, hospital costs and incidence of postoperative complications in the two groups were analyzed. Results All the patients were cured, the treatment effect of observation group and control group was statistically significant difference （P 〈0.05）; The blood loss, incision length, the number of cases of postoperative analgesia, postoperative stomach intestinal function recovery time, hospital stay in the observation group was signifi- cantly better than the control group. The incidence of complications in observation group was 6%, which was signifi- cantly lower than the control group （25%）, the difference was statistically significant （P 〈0.05）. Conclusion The efficacy of laparoscopic surgery is more superior in elderly patients with common bile duct stones, and more worthy in primary hospitals.