腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床探讨

Laparoscopic treatment of gallbladder stones combined choledochoscope biliary stones

目的：探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床疗效。方法将120例胆囊结石合并胆总管结石的患者根据治疗方法的不同分为观察组70例和对照组50例，观察组接受腹腔镜联合胆道镜治疗，对照组采用常规开腹手术治疗。观察比较两组患者手术情况、疗效及术后并发症发生情况。结果两组患者经治疗后，结石清除率均为100％。但观察组术中出血量、术后排气时间、下床时间以及总住院时间均低于对照组（ t＝6．655、6．386、4．657、7．675，均P＜0．05）。观察组患者术后并发症发生率8．6％（6/70）明显低于对照组的30．0％（15/50）（χ2＝9．276，P＜0．05）。结论腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石患者，有手术创伤小、恢复快等优点，疗效确切，值得临床推广应用。

Objective To investigate the effect of Laparoscopic treatment of gallbladder stones combined choledochoscope biliary stones .Methods 120 patients with gallbladder and common bile duct stones were divided into the observation group and control group according to different treatments methods ,who were treated with laparoscopy combined choledochoscope therapy and conventional open surgery respectively .Basic surgical,the efficacy and the occurrence of postoperative complications of the two groups were compared .Results The stone clearance rates of the two groups were 100%.However,the surgical trauma,blood loss,postoperative discharge time ,bed time and the total length of hospital stay of the observation group were significantly lower than those of the control group （ t=6.655, 6.386,4.657,7.675,all P〈0.05）.The incidence of complications of the observation group was significantly lower than that of the control group （8.6% vs 30.0%,χ2 =9.276,P〈0.05）.Conclusion Laparoscopic surgery com-bined treatment method choledochoscope with less trauma ,quicker recovery advantages of common bile duct stones in patients with gallstones have a definite therapeutic effect ,which should be widely applied .