腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床研究

Clinical study on the treatment of gallbladder and common bile duct calculi by laparoscopy combined with choledochoscopy

目的:探讨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:回顾分析175例胆囊结石合并胆总管结石患者的临床资料,其中90例行传统开腹手术(对照组),85例行腹腔镜联合胆道镜手术(研究组),记录两组患者手术时间、术后并发症等相关指标。结果:两组手术时间[(143.72±10.31)min vs.(152.41±11.62)min]差异无统计学意义(P>0.05),术中出血量[(181.41±13.25)ml vs.(83.65±11.32)ml]、胃肠功能恢复时间[(2.97±0.53)d vs.(1.27±0.45)d]、肛门排气时间[(3.38±1.36)d vs.(1.39±0.83)d]、术后住院时间[(14.46±0.62)d vs.(7.91±1.21)d]、术后并发症发生率(15.56%vs.8.23%)研究组优于对照组,差异有统计学意义(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具有安全性高、创伤小、有效、并发症少及利于术后康复等显著优势,具有一定的临床应用价值。

Objective：To investigate the clinical effect of laparoscopy combined with choledochoscopy in the treatment of gallbladder and common bile duct calculi.Methods：Retrospective analysis was performed on the clinical data of 175 patients with gallbladder and common bile duct calculi,among which 90 patients（control group） underwent traditional open surgery,and 85 patients（experimental group） were treated by laparoscopy combined with choledochoscopy.Operation time,postoperative complications and other related indicators of the two groups were recorded.Results：There was no significant difference in operation time [（143.72 ± 10.31） min vs.（152.41 ± 11.62） min] between the two groups（P〉0.05）.Compared with the control group,the experimental group was associated with less blood loss [（181.41 ± 13.25） ml vs.（83.65 ± 11.32） ml],shorter postoperative gastrointestinal function recovery time[（2.97 ± 0.53） d vs.（1.27 ± 0.45） d],less time of anal exsufflation [（3.38 ± 1.36） d vs.（1.39 ± 0.83） d],shorter hospital stay[（14.46 ± 0.62） d vs.（7.91 ± 1.21） d]and fewer complications（15.56% vs.8.23%）,the differences were statistically significant（P〈0.05）.Conclusions：Laparoscopy combined with choledochoscopy in the treatment of gallbladder and common bile duct calculi has certain clinical value with the significant advantages such as high safety,mini-invasion,effectivity,few complications and satisfying recovery.