腹腔镜肝切除联合胆道镜治疗肝内胆管结石的临床效果分析

Clinical results analysis of laparoscopic liver resection combined with choledochoscope in the treatment of hepatolithiasis

目的探讨腹腔镜肝切除联合胆道镜治疗肝内胆管结石(calculus of intrahepatic duct,CID)的临床效果。方法根据首次手术方法不同将本院收治的60例左肝内胆管结石患者分为研究组与对照组,研究组患者采取腹腔镜肝切除联合胆道镜治疗,对照组患者采取开腹手术治疗。结果研究组患者手术时间略长于对照组(P>0.05),术中出血量及排气时间均显著少于/短于对照组(P<0.01);两组患者术后并发症(胆瘘、术后出血、腹腔囊肿)发生率比较无显著差异(P>0.05),而研究组患者术后疼痛、切口感染以及术后1年随访的结石复发率均显著低于对照组(P<0.05或P<0.01)。结论腹腔镜肝切除联合胆道镜治疗左肝内胆管结石的可靠性与安全性均比较满意。

Objective To analyze the clinical results of laparoscopic liver resection combined with choledochoscope in the treatment of hepatolithiasis. Method According to the different surgical methods for the first time 60 patients with left hepatolithiasis were divided into study group and control group, study group underwent laparoscopic liver resection combined with choledochoscope, control group underwent open surgery. Result The operative time of study group was slightly more than control group（P〉0.05）, blood loss and exhaust time in study group were significantly less and shorter than control group（P〈0.01）; the incidence of biliary fistula, postoperative bleeding and abdominal cavity cyst after operation between the two groups were not statistically significant（P〉0.05）, while pain, wound infection after operation and stone recurrence rate after 1 year follow-up of study group were significantly lower than control group（P〈0.05 or P〈0.01）. Conclusion Laparoscopic liver resection combined with choledochoscope in the treatment of left hepatolithiasis is reliability and safety.