腹腔镜结合胆道镜治疗48例胆囊结石合并胆总管结石的临床疗效分析

Clinical Efficacy Analysis of Laparoscopic Combined with Choledochoscopy in the Treatment of 96 Patients with Cholecystolithiasis and Choledocholith

目的:研究探讨腹腔镜结合胆道镜治疗胆囊结石合并胆总管结石的临床效果。方法:选取本院2010年3月-2014年12月收治的胆囊结石合并胆总管结石患者96例作为研究对象,采用随机数字表法分为两组,每组48例。开腹组采用开腹常规手术治疗,腹腔镜+胆道镜组采用腹腔镜结合胆道镜微创治疗,对患者进行2年的随访。观察比较两组患者的治疗效果、术中出血量、手术时间、肛门排气时间、住院时间、VAS评分、围手术期的不良反应发生情况及随访2年的复发情况。结果:腹腔镜+胆道镜组手术效果明显优于开腹组,术中出血量、手术时间、肛门排气时间、住院时间明显少于开腹组,疼痛程度显著低于开腹组,围手术期不良反应发生情况明显优于开腹组,以上各项比较差异均有统计学意义(P<0.05)。两组复发情况比较差异无统计学意义(P>0.05)。结论:腹腔镜结合胆道镜治疗胆囊结石合并胆总管结石的临床效果确切,且微创治疗对患者的创伤小,术中出血量少,术后恢复迅速,有利于减少围术期的不良反应发生率以及减轻患者痛苦,值得临床推广应用。

Objective： To study the clinical efficacy of laparoscopic combined with choledochoscopy in the treatment of cholecystolithiasis and choledocholith.nethod： 96 patients with cholecystolithiasis and choledocholith in our hospital from March 2011 to February 2013 were selected and randomly divided into two groups, with each group 48 cases.The laparotomy group was treated with conventional open surgery, the laparoscopic and choledochoscopy group was given the treatment of laparoscopic combined with choledochoscope, two years follow-up was given to the patients.The treatment effect, blood loss during operation, operative time, passage gas anus time, hospital stays, VAS scores, the occurrence of adverse events and the recurrence rates of the two groups were recorded and compared.Result： The treatment effect, blood loss during operation, operative time, passage gas anus time, hospital stays, VAS scores and the occurrence of adverse events in the laparoscopic and choledochoseopy group were better than those in the laparotomy group, the differences were statistically significant （ P〈0.05 ） .The difference in the recurrence rates of the two groups was not statistically significant （P〉0.05） .Conclusion： The clinical effect of laparescopic combined with choledochoscopy in the treatment of cholecystolithiasis and choledocholith is obvious.Minimally invasive treatment has the advantages of small wounds, less blood loss and quick recovery.h can reduce the incidence of adverse reactions and patients＇ pain, it is worthy of clinical application.