腹腔镜联合胆道镜手术在胆囊结石合并胆总管结石治疗中的临床应用

Clinical application of different surgical methods in treating cholecystolithiasis and choledocholithiasis

目的:比较腹腔镜联合胆道镜手术与开腹手术治疗胆囊结石合并胆总管结石的临床疗效。方法:选取胆囊结石合并胆总管结石患者70例,按不同手术方式分为对照组和实验组,每组35例;对照组行开腹手术治疗,实验组行腹腔镜联合胆道镜治疗,比较两组患者术中、术后的综合情况。结果:1两组患者手术时间比较其差异无统计学意义(t=0.940,P>0.05),两组患者术中出血量、术中补液量、术后首次排气时间及住院时间等指标比较其差异均有统计学意义(t=15.242,t=16.234,t=31.650,t=6.924;P<0.05);2实验组患者术后出现切口感染、胆汁漏等并发症总发生率明显低于对照组(x2=6.437,P<0.05),两组患者结石残留率比较无显著差异。结论:腹腔镜联合胆道镜手术治疗胆囊结石合并胆总管结石具有创伤小、恢复快、并发症少等优点,值得临床推广应用。

Objective：To compare the curative effect between laparoscopy combined with choledochoscopy and open cholecystectomy in treating cholecystolithiasis and choledocholithiasis.Methods：70 patients with cholecystolithiasis and choledocholithiasis in our hospital from March 2010 to March 2013 were divided into Control group and Experimental group,35 cases of each group,Control group were given open cholecystectomy and Experimental group were given laparoscopy combined with choledochoscopy,the intraoperative and postoperative conditions of two groups were compared.Results：（1）There was no significant differences between two groups in operative time（t=0.940,P＞0.05）,there were significant differences about blood loss,intraoperative fluid volume,exhaust time,hospital stay time between two groups（t=15.242,t=16.234,t=31.650,t=6.924,P＜0.05）; （2）The incidence of postoperative complications of Experimental group was 5.8％,while the Control group was 28.6％,which was significant differences（x2=6.437,P＜ 0.05）,there was no significant differences between two groups in stone residual rate.Conclusion：Laparoscopy combined with choledochoscopy in treating cholecystolithiasis and choledocholithiasis has many advantages such as less trauma,quick recovery and less complications,which is better than the Open Cholecystectomy,it is worthy of clinical widely.