腔镜联合术与传统开放式手术治疗老年胆囊结石合并胆总管结石的临床疗效比较

Clinical effect of combined laparoscopic surgery on elderly patients with common bile duct stone and cholecystolithiasis

目的比较腔镜联合术与传统开放式手术治疗老年胆囊结石合并胆总管结石的临床疗效。方法选择2012-11~2015-11该院收治的老年胆囊结石合并胆总管结石患者100例,按照入院时间顺序分为观察组和对照组,每组50例,对照组采用传统开放式手术进行治疗,观察组采用腔镜联合术进行治疗,比较两组手术时间、术中出血量、住院时间、结石清除率以及手术并发症发生情况。结果对照组手术时间为(132.66±23.74)min,长于观察组的(105.21±17.85)min,差异有统计学意义(P<0.01);对照组术中出血量为(85.12±11.11)ml多于观察组的(33.14±5.12)ml,差异有统计学意义(P<0.01);对照组住院时间为(14.12±4.69)d,长于观察组的(5.87±1.64)d,两组差异有统计学意义(P<0.01)。观察组结石清除率为100.0%(50/50),对照组清除率为96.0%(48/50),两组比较差异无统计学意义(P>0.05)。对照组出现并发症9例(18.0%)症,观察组2例(4.0%),两组并发症总发生率比较差异有统计学意义(P<0.05)。结论腔镜联合术治疗老年胆囊结石合并胆总管结石手术时间较短、手术后并发症少、创口小,有利于老年人手术后恢复,值得临床应用推广。

Objective To study the clinical effect of combined laparoscopic surgery on elderly patients with common bile duct stone and cholecystolithiasis.Methods From November 2012 to November 2015, a total of 100 elderly patients with common bile duct stones and cholecystolithiasis in our hospital were taken as the clinical research subjects, and they were divided into the control group（n=50） and the observation group（n=50） according to their orders of admission. The control group was treated with traditional open surgery, and the observation group was treated with combined laparoscopic surgery. After the treatment, the operative time, blood loss, hospital stay, stone clearance rate and complication rate were compared between the two groups.Results The mean operative time of the control group（132.66±23.74）min was higher than that of the observation group（105.21±17.85）min（P〈0.01）. The intraoperative blood loss of the control group was significantly higher than that of the observation group（P〈0.01）.The hospital stay of the control group was significantly higher than that of the observation group（P〈0.01）. The stone clearance rate of the observation group（100.0%） was higher than that of the control group（96.0%）, but there was no significant difference between the two groups（P〉0.05）. The complication rate of the control group（18.0%） was significantly higher than that of the observation group（4.0%）（P〈0.05）.Conclusion The combined laparoscopic surgery has the advantages of less operative time and complications, and smaller wound for the elderly patients with common bile duct stones and cholecystolithiasis.