腹腔镜联合纤维胆道镜与常规开腹术式治疗胆囊并胆总管结石的临床对比

Comparative study of laparoscopy combined with fiberoptic choledochoscopy and conventional open surgery in treatment of gallbladder stones with common bile duct stones

目的:探讨腹腔镜联合纤维胆道镜与常规开腹术式治疗胆囊并胆总管结石临床效果及安全性差异.方法:回顾性分析承德医学院附属医院普外科2014-05/2015-05收治胆囊并胆总管结石患者共140例临床资料,其中行常规开腹术式治疗72例设为对照组,行腹腔镜联合纤维胆道镜术式治疗68例设为试验组;比较两组患者结石清除率,手术时间,术中出血量、术后首次排气时间、住院时间,镇痛药物使用率及术后并发症发生率等.结果:两组患者结石清除率比较差异无显著性意义(P>0.05);试验组患者手术时间、术中出血量、术后首次排气时间及住院时间均显著优于对照组,差异有显著性意义(P<0.05),试验组患者术后镇痛药物使用率和患者术后并发症发生率显著低于对照组,差异有显著性意义(P<0.05).结论:相较于常规开腹术式,腹腔镜联合纤维胆道镜术式治疗胆囊并胆总管结石具有微创、操作简便及术后恢复快等优势,有助于缓解术后疼痛和降低术后并发症发生风险.

AIM： To compare the efficacy and safety of laparoscopy combined with fiberoptic choledochoscopy and conventional open surgery in the treatment of gallbladder stones with common bile duct stones. METHODS： The clinical data of 140 patients who were treated at our hospital for gallbladder stones and common bile duct stones from May 2014 to May 2015 were retrospectively analyzed. They were divided into a control group （72 patients; undergoing conventional open surgery） and a treatment group （68 patients; undergoing laparoscopy combined with fiberoptic choledochoscopy）. The stone removal rate, operation time, bleeding volume, time to first exhaust, hospital stay, rate of postoperative analgesic usage, and incidence of postoperative complications were compared between the two groups.RESULTS： There was no significant difference in stone removal rate between the two groups（P 〉 0.05）. The operation time, bleeding volume, time to first exhaust and hospital stay in the treatment group were significantly better than those of the control group （P 〈 0.05）. The rate of postoperative analgesic usage in the treatment group was significantly lower than that of the control group （P 〈 0.05）. The incidence of postoperative complications in the treatment group was significantly lower than that of the control group （P 〈 0.05）. gallbladder stones with common bile duct stones possesses the advantages of minimal invasiveness, simple operation and rapid recovery, and can efficiently relieve the postoperative pain and reduce the risk of postoperative complications.