腹腔镜联合内镜治疗肝胆结石性疾病的应用价值

Value of laparoscopy combined with endoscopy in the treatment of liver diseases,gallstones

目的探讨腹腔镜联合内镜治疗肝胆结石性疾病的应用价值。方法收集我院2014年1月至2015年10月入院的100例肝胆结石性疾病患者随机分为三组。LACC组患者给予腹腔镜联合胆管镜外科保胆取石术(LACC)治疗,LC组患者给予腹腔镜胆囊切除术(LC)治疗,CC组患者给予胆管镜外科保胆取石术(CC)治疗,比较三组患者相关临床指标与并发症情况。结果三组患者总体术中出血量、手术时间、血红蛋白损失量与医疗费用存在显著性差异,具有统计学意义(P<0.01);两两比较后,LC组与CC组术中出血量与血红蛋白损失量组间比较均显著性高于LACC组,手术时间与医疗费用均显著性低于LACC组,具有统计学差异(P<0.01);三组患者总体术后总并发症发生率差异具有统计学意义(P<0.05);两两比较后,LC组与CC组术后总并发症发生率组间比较均明显高于LACC组,具有统计学差异(P<0.05)。结论腹腔镜联合胆管镜外科保胆取石术治疗肝胆结石性疾病效果最为显著,且术中创伤最小,并发症最少,但价格略高,具有借鉴性。

Objective To evaluate the value of laparoscopy combined with endoscopy in the treatment of liver and gallstone disease. Methods A hospital from January 2014 to October 2015 admitted 100 cases of liver and gallstone disease patients were randomly divided into three groups. LACC group were treated with arthroscopic surgery by laparoscopy combined with bile duct Paul gall stone surgery（ LACC） treatment,LC group were treated with laparoscopic cholecystectomy（ LC）treatment,CC group were treated with arthroscopic surgery gallbladder bile duct lithotomy（ CC） treatment,more three groups of patients with clinical parameters associated complications. Results Three groups of patients overall blood loss,operative time,the presence of hemoglobin loss and medical expenses significant difference was statistically significant（ P〈0. 01）; after pairwise comparison,LC group and CC group blood loss and between hemoglobin loss group were significantly higher than LACC group,operation time and medical costs were significantly lower than LACC group,there was a significant difference was statistically significant（ P〈0. 01）; three groups of patients overall total concurrency the presence of significant differences in the incidence of disease,with statistical significance（ P〈0. 05）; after pairwise comparisons between groups with total LC group incidence of postoperative complications CC group were significantly higher than LACC group,significant differences exist with statistics significance（ P〈0. 05）. Conclusion Combined laparoscopic gallbladder bile arthroscopic surgery lithotomy treatment of liver diseases,gallstones effect is most significant,and minimal trauma surgery,complications least,but the price is slightly higher,with Reference.