腹腔镜联合胆道镜微创手术治疗胆道结石的临床观察

Clinical Observation of laparoscopic combined with choledochoscope minimally invasive surgery for patients with biliary calculi

目的探讨腹腔镜联合胆道镜微创手术治疗胆道结石的临床疗效。方法选择胆道结石患者100例,随机分为观察组与对照组,每组50例。对照组患者以传统的开腹手术治疗,观察组患者采取腹腔镜联合胆道镜微创手术治疗,对两组患者的手术指标和并发症进行分析。结果与对照组相比,观察组手术时间、肠道恢复时间、引流管置入时间和住院时间更短,分别为(80.2±3.3)min、(25.5±8.0)d、(15.2±2.5)d和(16.6±4.1)d,两组比较差异有统计学意义(P<0.05)。对照组术后并发症发生率为14.0%,其中胆汁泄露4例,感染3例,观察组并发症发生率更低,仅为2.0%,两组比较差异有统计学意义(χ~2=9.023,P<0.05)。结论腹腔镜联合胆道镜治疗胆管结石的疗效显著,不需开腹,取石彻底、创伤较小,患者的住院时间短,有利于患者尽早康复出院,值得临床推广应用。

Objective To evaluate the clinical efficacy of laparoscopic combined with choledochoscope minimally inva- sive surgery for patients with biliary calculi. Methods 100 cases of patients with biliary calculi between January 2010 to December 2015 were treated, all the patients with biliary stones were divided into two groups with 50 cases in each group. Patients in control group were treated with traditional open surgery. Patients in observation group were treated with laparo- scopic combined with choledochoscope minimally invasive surgery. The surgery index and complications of patients in two groups were analyzed. Results Compared with the control group of patients, the observation group were operative time, recovery time of intestinal drainage tube placement time and shorter hospital stay were （ 80. 2 _＋ 3.3 ） min, （25. 5 -＋ 8. 0 ） d, （ 15.2 _＋ 2. 5 ） d and （ 16. 6 -＋ 4. 1 ） d, after a comparative analysis, the difference was statistically significant （ P 〈 0.05 ）. Postoperative complications occurred of patients in the control group was 14. 0% , of which 4 cases of bile leakage, infection in 3 cases, a lower incidence of complications was observed （ 2. 0% ） in the group of patients the difference was statistically significant （ χ2 = 9. 023, P 〈 0. 05 ）. Conclusion Laparoscopic combined with treatment of bile duct stones for treaeing biliary calculi has significant effect without laparotomy, stone removal thoroughly, less trauma, shorter hospital stay, good for patients discharged early, worthy of clinical application.