双镜联合与开腹手术治疗肝外胆管结石疗效对比

Clinical effect of double mirror and traditional laparotomy in treatment of cholecystolithiasis complicated with extrahepatic bile duct calculi: a comparison

目的:探讨双镜(腹腔镜联合胆道镜)与传统开腹手术治疗肝外胆管结石的临床疗效。方法:回顾性研究分析兵团医院接受双镜(腹腔镜联合胆道镜)治疗肝外胆管结石32例(观察组),开腹手术治疗肝外胆管结石32例(对照组)。比较2组患者手术成功率、手术时间、术中出血量、术后胃肠功能恢复时间、切口并发症、住院时间。结果:2组手术成功率比较差异无统计学意义(P>0.05)。2组患者手术时间、术中出血量、术后胃肠功能恢复时间、切口并发症、住院时间比较,双镜联合微创手术均优于开腹手术,差异有统计学意义(P<0.05)。结论:双镜微创手术治疗肝外胆管结石具有手术时间短、术中出血量少、术后胃肠功能恢复时间快、切口并发症少、住院时间短等优点,值得广大医务人员推广。

Objective： To compare the clinical effect of double mirror （laparoscope） and traditional laparotomy in treatment of cholecystolithiasis complicated with extrahepatic bile duct calculi.Methods： A retrospective study was performed to analyze the treatment history of a hospital from January 2012 to March 2016,during which 32 cases of extrahepatic bile duct calculi were treated by double mirror （laparoscope combined with biliary endoscope）,and 32 cases of extrahepatic bile duct calculi underwent laparotomy.The success rate,operation time,intraoperative hemorrhage,postoperative gastrointestinal function recovery time,incision complication and hospitalization time were compared between the two groups.Results： The success rate of the two groups was of no statistical difference （P 0.05）.There was,however,significant difference between the two groups in terms of operation time,intraoperative bleeding volume,postoperative gastrointestinal function recovery time,incision complications,and hospitalization time （P 0.05）.Dual-mirror combined with minimally invasive surgery is superior to laparotomy.Conclusion： Double-mirror combined with minimally invasive surgery for treatment of extrahepatic bile duct calculi has the advantages of shorter operation time,less intraoperative bleeding,faster postoperative gastrointestinal function recovery,fewer complications and shorter hospitalization.It is worth popularizing in clinical practice.