腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床疗效分析

Clinical analysis of laparoscopy combined with choledochoscopy in treatment of cholecystolithiasis with choledocholithiasis

目的探讨和分析腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床疗效。方法选择2015年12月~2016年12月我院收治的80例胆囊结石合并胆总管结石患者作为研究对象,均为择期手术,根据手术方法不同分为两组,每组40例。观察组实施腹腔镜联合胆道镜手术,对照组实施开腹手术。比较观察组与对照组患者的手术时间、出血量、术后肛门排气时间、住院时间及术后并发症情况。结果观察组无中转开腹病例及手术死亡病例。观察组患者的手术时间长于对照组,但出血量少于对照组,术后肛门排气时间及住院时间短于对照组,组间比较差异具有显著性(P<0.05)。观察组患者术后未发生胆道感染、胰腺炎、胆道残余结石及胃肠损伤,其并发症发生率为2.5%,明显低于对照组的35.0%,组间比较差异具有显著性(P<0.05)。结论腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石较开腹手术效果好,值得临床推广和应用。

Objective To investigate and analyze the clinical effect of laparoscopy combined With choledochoscopy in treatment of cholecystolithiasis with choledocholithiasis. Methods From December 2015 to December 2016 in our hospital, 80 cases of cholecystolithiasis and choledocholithiasis patients were selected as the research objects, all for elective surgery, according to the different surgical methods were divided into two groups, 40 cases in each group, the ob- servation group received laparoscopic surgery combined with choledochoscopy, the control group received open surgery. The operation time, blood loss, postoperative anal exhaust time, hospitalization time and postoperative complications were compared between the observation group and the control group. Results There was no conversion to open surgery and death in observation group. The operation time of the observation group was longer than that of the control group, but the amount of bleeding was less than that of the control group, the postoperative anal exhaust time and hospitaliza- tion time were shorter than those of the control group, and the difference was significant（P〈0.05）. The patients in the observation group did not occur biliary tract infection, pancreatitis, biliary residual stones and gastrointestinal injury af- ter surgery, the incidence rate of complications was 2.5%, was significantly lower than that in the control group（35.0%）, the difference was significant between groups（P〈0.05）. Conclusion Laparoscopy combined with choledochoscopy in the treatment of cholecystolithiasis with choledocholithiasis has better effect, and is worthy of clinical promotion and application.