腹腔镜与开腹胆总管探查术治疗胆总管结石的临床效果比较

Efficacy of laparoscopic vs open common bile duct exploration in patients with choledocholithiasis

目的:比较腹腔镜胆总管探查术(laparoscopic common bile duct exploration,LCBDE)与开腹胆总管探查术(open common bile duct exploration,OCBDE)治疗胆总管结石的临床效果.方法:随机抽取96例胆总管结石患者的临床资料,按照实际手术方案分为实验组(LCBDE)50例和对照组(OCBDE)46例,比较两组患者手术情况、术后情况以及并发症发生情况.结果:两组患者手术时间及术中出血量比较(130.33 min±11.06 min vs 128.68 min±10.88min)、(68.86 m L±10.97 m L vs 70.92 m L±11.26 m L),差异无统计学意义(P>0.05);实验组患者术后镇痛次数、胃肠功能恢复时间、术后住院时间及治疗总费用均显著低于对照组,(1.27次±0.50次vs 1.68次±0.72次)、(29.82 h±5.69 h vs 34.91 h±5.70 h)、(7.22 d±1.15 d vs 10.11 d±1.33 d)、(10068.44元±113.08元vs 13025.75元±116.20元),差异具有统计学意义(P<0.05);实验组患者术后切口感染发生率显著低于对照组,(0.00%vs8.70%),差异具有统计学意义(P<0.05).结论:LCBDE与OCBDE比较,创伤小、术后恢复时间短、治疗费用低,是治疗胆总管结石的优选手术方案.

AIM：To compare the efficacy between laparoscopic and open common bile duct exploration in patients with choledocholithiasis.METHODS：Ninety-six patients with choledocholithiasis were divided into a study group（50 cases） and a control group（46 cases）.The study group received laparoscopic common bile duct exploration,and the control group received open common bile duct exploration.The operative situation,postoperative situation,and complications were compared for the two groups.RESULTS：There was no significant difference in operative time or bleeding volume between the two groups（130.33 min ± 11.06 min vs128.68 min ± 10.88 min,68.86 mL ± 10.97 mL vs70.92 mL ± 11.26 mL,P 〉 0.05）.The number of times of postoperative analgesia use,time to gastrointestinal function recovery,postoperative hospitalization duration,and total treatment cost for the study group were significantly lower than those for the control group（1.27 ± 0.50 vs 1.68 ± 0.72,29.82 h ± 5.69 h vs 34.91 h ± 5.70 h,7.22 d ± 1.15 d vs 10.11 d ± 1.33 d,10068.44 ± 113.08 vs 13025.75 ± 116.20,P 〈 0.05）.The rate of incision infection for the experiment group was significantly lower than that for the control group（0.00%vs 8.70%,P 〈 0.05）.CONCLUSION：Laparoscopic common bile duct exploration is associated with less surgical trauma,shorter postoperative recovery time and lower treatment cost than open common bile duct exploration in patients with choledocholithiasis.