腹腔镜联合纤维胆道镜实施保胆手术的疗效

Efficacy of gallbladder-saving surgery by combined use of laparoscopy and fiber bile duct endoscopy

目的观察腹腔镜联合纤维胆道镜实施保胆手术的临床效果。方法胆囊结石患者132例分别采用腹腔镜联合纤维胆道镜实施保胆手术(A组,72例)和腹腔镜胆囊切除术(B组,60例),比较两组手术相关指标。结果A、B组手术时间相仿[(60.3±13.2)min vs.(53.6±7.3)min](P>0.05)。与A组比较,B组胆管损伤率高(1.7%vs.0),术后胆汁反流发生率高(20.3%vs.3.1%),住院时间长[(6.3±0.7)d vs.(4.3±0.5)d](P<0.05)。结论在胆囊结石患者,腹腔镜联合纤维胆道镜实施保胆手术能保持胆道完整,较常规腹腔镜胆囊切除术并发症少,术后恢复快。

Objective To observe the clinical efficacy of gallbladder-saving surgery by combined use of laparoscopy and fiber bile duct endoscopy.Methods A total of 132 patients with gallbladder stone was treated with gallbladder-saving surgery by combined use of laparoscopy and fiber bile duct endoscopy（group A,72cases）or conventional laparoscopic cholecystectomy（group B,60cases）.The operation-related outcomes were compared between two groups.Results The operation time of group A was similar to that of group B[（60.3±13.2）minutes vs.（53.6±7.3）minutes]（P〉0.05）.Compared to group A,group B had higher incidence rates of bile duct injury（1.7% vs.0）and bile reflux（20.3% vs.3.1%）,and longer hospital stay[（6.3±0.7）days vs.（4.3±0.5）days]（P〈0.05）.Conclusion Compared to conventional laparoscopic cholecystectomy,the gallbladdersaving surgery by combined use of laparoscopy and fiber bile duct endoscopy in the patients with gallbladder stone has the advantages of keeping the integrity of the bile duct,less complications and earlier recovery.