微创内镜联合术式与传统开放术式治疗胆囊并胆总管结石疗效及安全性比较

Clinical comparative study of minimal invasive endoscopy operation and conventional open operation in treatment of gallbladder stones combined with common bile duct stones

目的探讨微创内镜联合术式与传统开放术式治疗胆囊并胆总管结石临床效果及安全性差异。方法回顾性分析江苏大学附属医院普外科2014年5月-2015年5月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的72例患者设为对照组,行微创内镜联合术式治疗的68例患者设为试验组;比较两组患者结石清除率、围手术期临床指标、术后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统计学意义(P>0.05);试验组患者围手术期临床指标均显著优于对照组(P<0.05);试验组患者术后镇痛药物使用率显著低于对照组(P<0.05);同时试验组患者术后并发症发生率也显著低于对照组(P<0.05)。结论相较于传统开放术式,微创内镜联合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并降低术后并发症发生风险。

Objective To investigate the clinical effects and safety differences of minimal invasive endoscopy operation and conventional open operation in treatment of gallbladder stones combined with common bile duct stones. Methods The clinical data of 140 patients with gallbladder stones combined with common bile duct stones May 2014 to May 2015 in our hospital were selected. and They weredivided into control group（72 patients） with conventional open operation and treatment group（68 patients） with laparoscopy combined with biliary endoscopy,and the stone removal rate, perioperative clinical indicators, postoperative analgesic used rate and postoperative complications incidence of both groups were compared. Results There was no significant difference in stone removal rate between 2 groups（P〉0.05）. The perioperative clinical indicators of treatment group was significantly better than control group（P〈0.05）. The postoperative analgesic used rate of treatment group was significantly lower than control group（P〈0.05）. The postoperative complications incidence of treatment group was significantly lower than control group（P〈0.05）. Conclusions Compared with conventional open operation, minimally invasive endoscopy operation in treatment of gallbladder stones combined with common bile duct stones possesses the advantages including minimal invasive, simple operation and rapid recovery process and can efficiently relieve the postoperative pain and reduce the risk of postoperative complications.