开腹手术和腹腔镜手术治疗老年胆囊及胆总管结石

Clinical effects of laparoscopy and open surgery on elderly patients with cholecyslithiasis and choledocholithiasis

目的探讨开腹手术和腹腔镜手术治疗老年胆囊及胆总管结石的临床疗效。方法将2010年5月至2013年5月收治的156例胆囊及胆总管结石的老年患者，随机分为开腹组和腹腔镜组，每组78例。开腹组采用传统开腹手术进行治疗，观察组采用腹腔镜手术进行治疗，比较两组患者的临床治疗效果。结果经治疗后，腹腔镜组总有效率（93．59％）明显高于开腹组（83．33％），两组比较差异有统计学意义（χ2=4．0193，P〈0．05）；两组手术时间比较差异未见统计学意义（P〉0．05）；腹腔镜组术中出血量、术后排气时间、住院时间和胃肠功能恢复时间均显著短于开腹组，两组比较差异有统计学意义（P均〈0．01）；同时，开腹组总并发症发生率（23．08％）明显高于腹腔镜组（8．97％），两组比较差异有统计学意义（χ2=5．7637，P〈0．05）。结论腹腔镜治疗老年胆囊及胆总管结石疗效好，术中创伤小，出血量少，术后并发症发生率低，值得临床推广应用。

Objective To investigate the clinical effects of laparoscopy and Open surgery on elderly patients with cholecyslithiasis and choledocholithiasis. Methods The 156 patients who got medical treatment in our hospital from May 2010 to May 2013 were randomly divided into the open group and the laparoscopy group, each group had 78 patients, and patients in open group were treated with laparotomy, while patients in laparoscopy group were given laparoscopy. Then the clinical effects of the two groups were compared. Results After treatment, the total effective rate in laparoscopy group was significantly higher than that in the open group（ χ2 =4. 0193, P 〈0.05） ; There was no significant difference in the opera- tion time between the two groups（ P 〉 0.05 ） ; the blood loss, the time of anal passage of gas, postoperative hospital stay and postoperative stomach intestinal function recover time in the laparoscopy group were significantly shorter than those in the open group（ P each 〈 0. 01 ） ; Simultaneously, the incidence of complications in laparoscopy group was 8. 97%, which was significantly shorter than that in the open group（23.08% ）, the difference was significant（ χ2 = 5. 7637, P 〈 0. 05 ）. Conclusions The curative effect of laparoscopy on elderly cholecyslithiasis and choledocholithiasis is good, and has minimal wound, less blood loss, fewer complications, so it is worthy of promotion and application.