腹腔镜联合胆道镜治疗复杂性肝内外胆管结石的效果分析

Clinical effect analysis of laparoscopic combined with choledochoscopy in the treatment of complicated intrahepatic and extrahepatic bile duct stones

目的分析联合应用腹腔镜、胆道镜在复杂性肝内外胆管结石患者中的治疗效果。方法选取2013年10月至2015年10月上海市普陀区利群医院收治的复杂性肝内外胆管结石患者100例。随机分为观察组及对照组各50例。观察组患者接受腹腔镜联合胆道镜取石治疗,对照组患者行开腹治疗。结果观察组术中出血量和手术时间均显著小于对照组(P<0.05),术后下床时间及术后住院时间亦显著短于对照组(P<0.05);观察组结石取净率显著高于对照组(P<0.05),二次手术率显著低于对照组(P<0.05);在术后随访过程中,观察组并发症总发生率显著低于对照组(P<0.05)。结论腹腔镜联合胆道镜治疗复杂性肝内外胆管结石较常规开腹治疗效果更好,值得在临床进行推广。

Objective To analyze the clinical effect of laparoscopic combined with choledochoscopy in the treatment of complicated intrahepatic and extrahepatic bile duct stones. Methods One hundred patients with complicated intrahepatic and extrahepatic bile duct stones from October 2013 to October 2015 in our hospital were selected and randomly divided into observation group and control group. Patients in observation group received laparoscopic combined with choledochoscopy treatment, while the control group received the laparotomy. Results The perioperative bleeding and operative time of patients in observation group were significantly less than control group（P〈0.05）. The postoperative activity time and postoperative hospital stay were significantly less than control group（P〈0.05）. The stone free rate in observation group was significantly higher than in the control group（P〈0.05）, meanwhile the reoperation rate was significantly lower than the control group（P〈0.05）. During the follow-up, the total incidence of complications was significantly lower than that in the control group（P〈0.05）. Conclusion Laparoscopic combined with choledochoscopy in the treatment of complicated intrahepatic and extrahepatic bile duct stones improved the therapeutic effect and reduce the incidence of complications.