微创保胆取石术联合牛磺熊去氧胆酸与腹腔镜胆囊切除术治疗胆囊结石的疗效对比

Effect contrastive study for treatment of cholecystolithiasis by minimally invasive cholecystolithotomy with gallbladder reservation combined tauroursodeoxycholic acid and laparoscopic cholecystectomy

目的：探讨微创保胆取石术联合牛磺熊去氧胆酸治疗胆囊结石的疗效，并与腹腔镜胆囊切除术疗效对比。方法选取2011年4月～2013年4月我院治疗的胆囊结石患者80例，随机分为研究组和对照组各40例，研究组采用微创保胆取石术联合牛磺熊去氧胆酸治疗。对照组给予常规腹腔镜胆囊切除手术治疗。观察两组患者手术时间、术中出血量、术后住院时间及饮食恢复时间；手术前与术后1年研究组患者症状、胆囊壁厚度、胆囊收缩功能及复发情况。结果研究组术中出血量明显少于对照组，术后饮食恢复时间明显缩短（P ＜0.05）。随访1年后，研究组症状发生率明显降低，胆囊壁厚度明显变薄，胆囊收缩功能明显改善（P ＜0.05）；且胆囊结石复发率仅为5.0%。结论微创保胆取石术联合牛磺熊去氧胆酸治疗胆囊结石患者疗效优于腹腔镜胆囊切除术，术后能明显改善胆囊收缩功能，降低复发率。

Objective To investigate the curative effect of minimally invasive cholecystolithotomy with gallbladder reservation combined tauroursodeoxycholic acid in the treatment of cholecystolithiasis,and contrast with laparoscopic cholecystectomy. Methods 80 patients with cholecystolithiasis from 2011 April to 2013 April in our hospital were randomly divided into study group and control group with 40 cases in each group,the study group were treated with minimally invasive cholecystolithotomy with gallbladder reservation combined tauroursodeoxycholic acid treatment. The control group was given conventional laparoscopic cholecystectomy treatment.The operation time,intraoperative bleeding volume,postoperative hospitalization time and time to resume diet of patients in two groups and symptoms,gallbladder wall thickness,gallbladder contraction function and recurrence rate of patients in study group before operation and 1 year after operation were observed. Results The intraoperative bleeding volume of the study group was significantly less than the control group,postoperative time to resume diet was significantly shorter（P 〈0.05）. After one year of follow-up,the incidence of symptoms of the study group was significantly lower,gallbladder wall thickness was thinned,gallbladder contraction function improved significantly（P 〈 0.05）;and the recurrence rate of cholecystolithiasis was only 5.0%. Conclusion The effect of minimally invasive cholecystolithotomy with gallbladder reservation combined tauroursodeoxycholic acid in the treatment of cholecystolithiasis is better than laparoscopic cholecystectomy,and it can obviously improve the gallbladder contraction function,reduce the recurrence rate.