腹腔镜胆总管探查术与内镜下十二指肠乳头括约肌切开术治疗胆总管结石的疗效对比

Comparison of Laparoscopic common Bile Duct Exploration and Endoscopic Duodenal Sphincterotomy in the Treatment of Common Bile Duct Stones

目的:探讨与比较腹腔镜胆总管探查术与内镜下十二指肠乳头括约肌切开术治疗胆总管结石的疗效。方法:收集2016年1月至2016年9月入院的200例胆总管结石患者,随机分为两组,腹腔镜组患者给予腹腔镜胆总管探查术,内镜组患者则采用内镜下十二指肠乳头括约肌切开术,比较两组患者围手术期相关临床指标、术后监测指标、围手术期与远期并发症。结果:腹腔镜组患者术口长度、术中失血量、手术时间、胃肠功能恢复时间、住院时间、急性胰腺炎、总体围手术期并发症发生率、结石复发与总体远期并发症发生率低于内镜组,医疗费用与结石一次清除率高于内镜组;术后24h WBC、CRP与AMY水平组间比较均显著性低于内镜组,差异具有统计学意义(P<0.01);残石率、反流性胆管炎与乳头狭窄发生率低于内镜组,存在明显差异(P<0.05)。结论:腹腔镜胆总管探查术治疗胆总管结石的疗效更为显著,创伤更低,安全性更高,具有借鉴意义。

Objective：To investigate the efficacy of laparoscopic common bile duct exploration and endoscopic duodenal sphincterotomy in the treatment of common bile duct stones.Methods： 200 patients with choledocholithiasis who were enrolled from January 2016 to September 2016 were randomly divided into two groups.Laparoscopic patients underwent laparoscopic common bile duct exploration.Endoscopic group Intra-papillary sphincterotomy, compared the two groups of patients with perioperative clinical indicators, postoperative monitoring indicators, perioperative and long-term complications.Results： The length of the patients in the laparoscopic group, the amount of blood loss during operation, the time of operation, the recovery time of gastrointestinal function, the time of hospitalization, acute pancreatitis, the incidence of total perioperative complications, recurrence of stone recurrence and overall long-term complication （P 〈0.05）.There was significant difference between the two groups （P 〈0.05）.Conclusion：The efficacy of laparoscopic common bile duct exploration in the treatment of common bile duct stones is more significant, lower trauma, higher safety, with reference.