腹腔镜联合胆道镜取石术治疗肝内胆管结石的临床疗效

Clinical efficacy of laparoscopic combined with choledochoscope in the treatment of intrahepatic bile duct stones

目的探讨腹腔镜与胆道镜取石术在肝内胆管结石患者治疗中的联合应用价值。方法选取2011年3月-2013年3月收治的肝内胆管结石患者98例,将患者随机分为研究组和对照组,每组49例。对照组患者采用单纯腹腔镜手术治疗,研究组患者采用腹腔镜联合胆道镜取石术治疗。并分别对两组患者的临床治疗情况、手术指标改善情况、并发症发生情况进行比较和分析。结果与对照组患者相比,研究组患者结石取净的比率有所提高,高达93.88%,差异无显著性（P〉0.05）;研究组患者手术时间明显延长,术中出血量明显减少,术后排气时间和住院时间均明显缩短,差异有显著性（P〈0.05）;研究组患者并发症发生率较对照组患者显著降低,差异有显著性（P〈0.05）。结论腹腔镜联合胆道镜取石术对于提高肝内胆管结石患者的临床疗效具有积极的临床意义。

[ Objective ] To study the clinical application value of laparoscopic combined with choledochoscope in the treatment of intrahepatic bile duct stones. [Methods ] From March 2012 to March 2012, 98 patients with in- trahepatic bile duct stones in our hospital were divided into study group and control group randomly. There were 49 cases in each group. The patients in control group were treated with laparoscopic surgery only. The patients in study group were treated with laparoscopie combined with choledochoscope. The situation of clinical treatment, surgical in- dicators to improve and the occurrence of complications of the patients in two groups were compared and analyzed. [ Results ] Compared with the control group, the ratio of stones completely removed in study group was increased, up to 93.88%, there were no statistically significant （P 〉0.05）. Compared with the control group, the surgery time in study group was prolonged, blood loss was reduced, time and duration of hospitalization after discharge were short- ened significantly （P 〈0.05）. Compared with the control group, the incidence of complications in study group was re- duced significantly （P 〈0.05）. [ Conclusion ] Laparoscopic combined with eholedoehoscope has positive clinical sig- nificance for improving clinical efficacy, intraoperative and postoperative indicators of patients with intrahepatic bile duct stones.