腹腔镜联合胆道镜治疗胆总管结石的临床效果分析

Clinical effect analysis of laparoscopy combined with biliary endoscopy in the treatment of choledocholithiasis

目的：探讨腹腔镜联合胆道镜治疗胆总管结石的临床疗效。方法以我院2012年1月～2014年1月微创外科收治的98例胆总管结石患者为研究对象，根据治疗方式不同分为对照组与观察组，对照组给予传统开腹手术治疗，观察组给予腹腔镜联合胆道镜治疗，观察比较两组患者的治疗效果及切口感染的发生情况。结果观察组治疗总有效率为95.9%，明显高于对照组的77.6%（P〈0.05）；观察组手术时间、住院时间、肛门排气时间短于对照组，术中出血量少于对照组，切口感染率低于对照组，差异有统计学意义（P〈0.05）。结论与传统开腹手术比较，腹腔镜联合胆道镜治疗胆总管结石的效果更佳，能缩短住院时间，降低术后切口感染的发生率，具有创伤小、术中出血量少的优势，能促进患者术后康复，具有较高的应用价值，值得推广。

Objective To evaluate the clinical efficacy of laparoscopy combined with choledochoscopy in the treatment of choledocholithiasis. Methods Ninety-eight patients with choledocholithiasis treated in the minimally invasive surgery department of our hospital from January 2012 to January 2014 were selected as the study subjects and divided into control group and observation group according to different treatment methods.The control group was given traditional laparotomy treatment and the observation group was given laparoscopy combined with choledochoscopy treatment.The treatment effects and occurrence of incision infection between two groups of patients were analyzed comparatively. Results The total effective treatment rate of the observation group was 95.9%,which was significantly higher than the 77.6% of the control group.The observation group was lower than the control group in operative time,intraoperative blood loss,length of hospital stay,anal exhaust time and wound infection rate,with significant differences （P〈0.05）. Conclusion Compared to traditional laparotomy,laparoscopy combined with choledochoscopy shows better effect,can shorten length of hospital stay,reduces incidence of postoperative incision infection,has the advantages of small trauma and less intraoperative blood loss and can promote fast postoperative rehabilitation in the treatment of choledocholithiasis,which is of high application value and worthy of promotion.