腹腔镜联合胆道镜保胆取石术在胆囊结石治疗中的有效性及可行性

The effectiveness and feasibility of laparoscope combined with choledochoscope minimally invasive cholecystolithotomy in the treatment of gallstones

目的探讨腹腔镜联合胆道镜保胆取石术在胆囊结石治疗中的有效性及可行性。方法选取2013年8月至2015年8月在本院诊治的108例胆囊结石患者，将其依据随机方式划分为对照组和观察组，每组54例，观察组采取腹腔镜联合胆道镜微创保胆取石术予以治疗，对照组则采取腹腔镜胆囊切除术给予治疗，对比两组并发症及手术效果。结果观察组在术中出血量（11．0±1．8）ml、术后胃肠功能恢复时间（14．3±2．7）h、手术时间（40．2±3．1）min、住院时间（5．1±0．8）d等指标均低于对照组[（74．4±11．7）ml、（27．0±2．9）h、（56．3±2．8）min、（9．1±1．6）d]，两组比较差异有统计学意义（P〈0．05）；观察组术后并发症发生率低于对照组（3．70％vs．12．96％），两组比较差异有统计学意义（P〈0．05）。结论针对胆囊结石患者，对其采用腹腔镜联合胆道镜微创保胆取石术实施治疗，创伤小，效果显著，可对胆囊功能较好的施加保护，且术后恢复时间短，在临床中具有良好的应用价值。

Objective To explore the effectiveness and feasibility of laparoscope combined with choledochoscope minimally invasive cholecystolithotomy in the treatment of gallstones. Methods 108 patients with gallstones in our hospital from August 2013 to August 2015 were randomly divided into control group and observation group, 54 cases in each group. Observation group underwent laparoscope combined with choledochoscope minimally invasive cholecystolithotomy, while control group underwent laparoscopic cholecystectomy. Effect and complications were compared between two groups. Results The intraoperative blood loss, the recovery time of gastrointestinal function after surgery, the operation time, hospitalization time in observation group were all less than those in control group [（11.0±1.8）ml vs.（74.4±11.7）ml, （14.3±2.7） h vs.（27.0±2.9）h, （40.2±3.1）min vs.（56.3±2.8）min, （5. 1±0.8）d vs.（9.1±1.6）d], with statistically significant differences between two groups （P〈0.05）. The incidence of complications in observation group was significantly lower than that in control group, with statistically significant difference between two groups （P〈0.05）. Conclusion For patients with gallstones, laparoscope combined with choledochoscope minimally invasive cholecystolithotomy has the advantages of small trauma, significant effect, which can better protect the function of gallbladder, with short postoperative recovery time, with good application value in clinical practice.