腹腔镜与开腹胆总管探查术的疗效比较

Comparison of Efficacy Between Laparoscopic and Open Common Bile Duct Exploration

目的对比腹腔镜与开腹胆总管探查T管引流术对胆总管结石的治疗效果。方法回顾性分析2011年7月至2013年7月两年间在新疆医科大学一附院行胆总管探查取石70例患者临床资料,分为两组:腹腔镜胆总管探查术组(laparoscopic common bile duct exploration,LCBDE)与开腹胆总管探查术组(open common bile duct exploration,O CBDE),所有病例均放置"T"管引流。对比术中、术后两组治疗效果、术中情况、术后并发症发生情况。结果 2组手术病人均顺利出院。在术中出血量、手术时间、术后胆瘘、腹腔脓肿,两组无明显差异(P>0.05)。然而住院时间、住院费用、胃肠道功能恢复时间、术后镇痛的次数,LCBDE组明显优于O CBDE组(P<0.05)。结论腹腔镜联合胆道镜治疗胆总管结石疗效确切,安全、可靠,与传统开腹手术相比具有创伤小、术后恢复快、住院时间短、费用低等优点,值得在临床广泛应用。

Objective To compare the treatment effect between laparoscopic and open common bile duct exploration and T tube drainage of common bile duct stones. Methods the clinical data of 70 patients were retrospectively analyzed by common bile duct exploration from July 2011 to July 2013 in First Affiliated Hospital of Xinjiang Medical University, divided into two groups： laparoscopic common bile duct exploration and open common bile duct exploration. All patients were placed on a ＂T＂ tube drainage. Contrast effect of treatment, the intraoperative indicators and postoperative complications. Results The clinical data of the two groups of patients with a comparative analysis and the two surgical patients were cured. In blood loss, operative time, postoperative biliary fistula, abdominal abscess, LCBDE group and OCBDE group had no significant difference（P〉0.05）. However, The length of time in hospital, cost of hospitalization, the time of gastrointestinal function recovery, the number of postoperative analgesia, LCBDE group was significantly better than OCBDE group（P〈0.05）. Conclusion Laparoscope combined with choledochoscope of the curative effect of treatment efficacy on common bile duct calculi is exact,safe,reliable and compared with traditional open surgery, has the advantages of less trauma, faster recovery, shorter thelength of time, and lower cost, it isworth widely used in clinical.