腹腔镜联合胆道镜钬激光碎石治疗肝胆管结石55例临床分析

Laparoscopy plus cholangioscopic holmium laser lithotripsy for intrahepatic gall stones in 55 cases

目的探讨腹腔镜联合胆道镜钬激光碎石治疗肝胆管结石的疗效及安全性。方法 110例胆囊合并胆管结石患者根据手术方式不同分为腹腔镜组和开腹手术组各55例,比较2组手术时间、术后肠功能恢复时间、术后镇痛剂使用、切口感染例数、住院时间和残留结石发生率。结果腹腔镜组手术时间为(89.0±9.6)min、术后肠功能恢复时间(1.4±0.5)d、术后镇痛剂使用10例、无切口感染、住院时间(5.5±1.2)d、残留结石发生率(1.8%),开腹组分别为(110.0±12.5)min、(3.5±0.7)d、34例、切口感染6例、(12.9±1.8)d、12.7%,2组比较差异均有统计学意义(P<0.05)。结论腹腔镜联合胆道镜钬激光碎石治疗肝胆管结石创伤小、恢复快、安全有效、并发症少。

Objective To evaluate the therapeutic effect and safety of laparoscopy plus cholangioscopic holmium laser lithotripsy in the treatment of intrahepaitc gall stones. Methods A total of 110 cases of gallstone complicated with biliary stones were divided into laparoscopy group and open surgery group, with 55 cases in each group. The operation duration, recovery of intestinal function after surgery, usage of analgesic after operation, incidence of incision infection, hospitalization stay, and the incidence of residual biliary stones. Results The operation duration, postoperative intestinal function recovery time, analgesic using number, incision infection number, hospitalization stay, and the incidence of residual biliary stones were （89.0±9.6） minutes, （1.4±0.5） days, 10 cases, 0 case, （5.5±1.2） days, and 1.8% in laparoscopic group, and （110.0±12.5） minutes, （3.5±0.7） days, 34 cases, 6 cases, （12.9±1.8） days, and 12.7% in open surgery group, showing significant differences between two groups （P〈 0.05）. Conclusions Laparoscopy plus cholangioscopic holmium laser lithotripsy is minimally invasive, safe and effective, with quick recovery and few complications.