腹腔镜联合胆道镜治疗胆囊合并胆总管结石的临床疗效

Clinical Curative Effect of Laparoscope Combined Choledochoscope in Treatment of Gallbladder and Choledocholithiasis

目的探究腹腔镜联合胆道镜治疗胆囊合并胆总管结石的临床疗效。方法方便选取沭阳县人民医院普外科自2013年1月—2017年2月收治的38例腹腔镜联合胆道镜治疗胆囊合并胆总管结石患者纳入实验组研究范围,筛选同期行传统开腹手术的30例患者将其纳入对照组,观察比较两组患者手术、术后恢复及及术后并发症情况。结果实验组术中出血量为(85.86±13.51)m L,少于对照组的(189.35±13.86)m L;切口长度为(0.80±0.50)cm,小于对照组的(17.93±2.91)cm;术后镇痛药使用率为15.79%、低于对照组的90.00%;肛门排气时间为(1.39±0.88)d、离床时间为(40.01±18.71)h、术后住院时间为(8.04±1.09)d均较对照组的(3.17±1.36)d、(90.07±26.59)h、(14.78±0.91)d短;且实验组术后仅发生2例不良反应,其中1例胆漏,1例胰腺炎,发生率仅为5.26%,显著低于对照组的23.33%,以上对比均差异有统计学意义(P<0.05)。结论腹腔镜联合胆道镜治疗胆囊合并胆总管结石的临床疗效显著,具出血量少、创口小、术后恢复快、并发症少等优势。

Objective To study the clinical curative effect of laparoscope combined choledochoscope in treatment of gallbladder and choledocholithiasis. Methods Convenient selection 38 cases of patients with gallbladder and choledocholithiasis admitted and treated in our hospital from January 2013 to February 2017 were selected as the experimental group, while 30 cases of patients with traditional laparotomy surgery at the same period were selected as the control group, and the operation and postoperative recovery and postoperative complications were compared between the two groups. Results The intraoperative bleeding amount in the experimental group was less than that in the control group[（85.86±13.51）m L vs（189.35±13.86）m L,and the cut length was shorter than that in the control group, [（0.80±0.50）cm vs（17.93±2.91）cm], and the use rate of postoperative analgesic drugs was lower than that in the control group（15.79% vs 90.00%）, and the anus exhaust time, time to leave bed and length of stay after surgery were shorter than those in the control group, [（1.39 ±0.88）d,（40.01 ±18.71）h,（8.04±1.09）d vs（3.17±1.36）d,（90.07±26.59）h,（14.78±0.91）d], and there were 2 cases with adverse reactions after surgery in the experimental group, including 1 case with biliary leakage and 1 case with pancreatitis, and the incidence rate was only5.26%, which was obviously lower than that in the control group,（23.33%）, and the difference was statistically significant（P〈0.05）. Conclusion The clinical curative effect of laparoscope combined choledochoscope in treatment of gallbladder and choledocholithiasis is obvious with less bleeding amount, small wound, rapid recovery after surgery and few complications.