改良入路及胆管途径入路腹腔镜胆道探查术治疗老年胆总管结石的疗效

Clinical study on the treatment of senile choledocholithiasis with improved approach and bile duct approach of laparoscopic biliary tract exploration

目的对比改良入路及胆管途径入路的腹腔镜胆道探查术治疗老年胆总管结石的疗效。方法选取92例老年胆总管结石患者,随机分为改良组与常规组,各46例。改良组采取改良入路,常规组采取常规入路。比较两组术中出血量、胆总管缝合时间、胃肠道功能恢复时间、住院时间,手术前后体温、白蛋白与总胆红素水平、并发症与结石复发情况。结果改良组术中出血量、胆总管缝合时间、胃肠道功能恢复时间、住院时间均低于常规组(P<0.05)。改良组术后3 d体温低于常规组(P<0.05)。改良组术后并发症总发生率低于常规组(P<0.05)。两组均无结石复发。结论改良入路的腹腔镜胆总管探查术术中出血少、胆总管缝合时间短、术后恢复快,体温波动小、并发症少,值得推广应用。

Objective To investigate the improved approach and bile duct approach of laparoscopic biliary tract exploration for the treatment of the elderly patients with common bile duct stones.Methods Ninetytwo elderly patients with common bile duct stones were enrolled and randomly divided into the improved group and the conventional group,with 46 cases in each group.The time of hemorrhage,the time of common bile duct suture,the recovery time of gastrointestinal function,the time of hospitalization,body temperature,albumin and total bilirubin levels,complications and recurrence of stones were recorded and compared between the two groups.Results The time of hemorrhage,the time of common bile duct suture,the recovery time of gastrointestinal function and the time of hospitalization in the improved group were lower than those in the conventional group（P〈0.05,respectively）.The body temperature of patients in the improved group was lower than that in the conventional group on 3 days after surgery（P〈0.05）.The overall incidence of postoperative complications in the improved group was lower than that in the conventional group（P〈0.05）.No recurrence of stones was observed in both two groups.Conclusion The improved approach for laparoscopic common bile duct exploration surgery results in less bleeding,short common bile duct suture time,rapid postoperative recovery,less body temperature fluctuations and less complications,deserving popularization.