不同术式治疗胆囊单发性结石及胆固醇息肉的临床疗效比较

Comparative analysis of laparoscopic assisted laparoscopic cholecystectomy and laparoscopic cholecystectomy in the treatment of solitary stone and cholesterol polyps

目的探讨腹腔镜辅助胆管镜保胆手术与腹腔镜胆囊切除术治疗胆囊单发性结石及胆固醇息肉的临床疗效差异。方法选取我院2015年1月—2016年1月所收治患者70例,随机分为保胆组和胆囊切除组。保胆组35例,行腹腔镜辅助胆管镜保胆手术;胆囊切除组35例,采用腹腔镜胆囊切除。比较2组术中、术后情况,并记录2组患者并发症发生率。结果保胆组术中出血量为(24.28±6.77)m L、排气时间为(11.31±3.82)h,均显著低于胆囊切除组,差异具有统计学意义(P<0.05);另外,2组在手术时间、住院时间、住院费用等方面无显著差异(P>0.05)。保胆组仅发生1例胆管感染,其并发症发生率为2.86%;胆囊切除组发生10例腹泻、1例胆管感染及1例肝纤维化,并发症发生率为34.3%,组间比较差异具有统计学意义(P<0.05)。结论腹腔镜辅助胆管镜保胆术应用于胆囊单发结石及胆固醇息肉临床治疗中,疗效肯定,安全可靠,还可以保留胆囊功能,改善预后质量,值得在临床推广应用。

Objective To explore the difference of clinical efficacy between laparoscopic assisted laparoscopic cholecystectomy and laparoscopic cholecystectomy in the treatment of patients with gallstone and cholesterol polyps. Methods In our hospital from January 2015 to January 2016,70 patients were admitted to the hospital,and were randomly divided into gallbladder preserving group and cholecystectomy group. Gallbladder preserving group was performed in 35 cases,35 cases were treated by laparoscopic assisted laparoscopic cholecystectomy,and cases of cholecystectomy group were treated by laparoscopic cholecystectomy.The two groups were compared,and the incidence of complications in two groups were recorded.Results Paul bile group bleeding（24.28 ±6.77）m L,the exhaust time（11.31 ±3.82）h,were significantly lower than the cholecystectomy group,the difference was statistically significant（P〈0.05）;in addition,the two groups in the operation time,hospitalization time,hospitalization costs,no significant difference（P〈0.05）.Paul bile group had only 1 cases with biliary tract infection,the incidence of complications was 2.86%;cholecystectomy group 10 cases of diarrhea,1 cases of biliary tract infection and 1 cases of hepatic fibrosis,the complication rate was 34.3%;comparison between groups,the difference was statistically significant（P〈0.05）.Conclusion Laparoscopic assisted choledochoscope surgery used in clinical treatment of solitary gallbladder stones and cholesterol polyps,curative effect,safe and reliable,can also retain the gallbladder function,improve the prognosis,it is worthy of clinical application.