腹腔镜下胆囊切除胆道探查术与开腹手术治疗老年胆囊疾病合并胆总管结石的临床效果分析

Clinical effect analysis of laparoscopic cholecystectomy bile duct exploration and laparotomy in the treatment of elderly patients with gallbladder diseases complicated with choledocholithiasis

目的分析腹腔镜下胆囊切除胆道探查术与开腹手术治疗老年胆囊疾病合并胆总管结石的临床效果。方法选取我院2015年2月~2016年6月收治的80例老年胆囊结石合并胆总管结石患者,按照随机数字表法分成对照组和实验组,各40例。对照组选择传统开腹手术治疗,实验组选择腹腔镜下胆囊切除胆道探查术治疗,比较两组的临床效果、切口长度、手术时间、术中出血量、术后通气时间、住院时间和术后并发症发生情况。结果实验组的临床治疗总有效率为97.5%,高于对照组的77.5%,差异有统计学意义(P<0.05)。实验组的手术时间、术后通气时间、住院时间、切口长度短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05)。实验组的并发症发生率为2.5%,显著低于对照组的20.0%,差异有统计学意义(P<0.05)。结论应用腹腔镜下胆囊切除胆道探查术治疗老年胆囊疾病合并胆总管结石能取得比较理想的效果,具有微创、术后并发症发生率低、恢复快等优点,值得临床推广与应用。

Objective To analyze the clinical treatment effect of laparoscopic cholecystectomy bile duct exploration and laparotomy in the treatment of elderly patients with gallbladder diseases complicated with choledocholithiasis.Methods80 patients suffering gallstones/bile duct stones hospitalized in our hospital from February 2015 to June 2016 were selected and randomly divided into the control group and the experiment group,40 cases in each group.Patients of the control group were applied with the conventional laparotomy treatment,and the experiment group was treated with laparoscopic cholecystectomy bile duct exploration.The clinical efficacy,incision length,operation time,intraoperative blood loss,postoperative ventilation time,length of stay and postoperative complications between the two groups were compared.Results The total effective rate of clinical treatment in the experimental group was 97.5%,which was higher than77.5% in the control group,with significant difference（P〈0.05）.The operation time,postoperative ventilation time,length of stay and incision length in the experiment group was shorter than that in the control group,and the amount of bleeding in the operation in the experiment group was less than that in the control group,with significant difference（P〈0.05）.The complication rate of the experiment group was 2.5%,which was significantly lower than that of the control group（20.0%）,with significant difference（P〈0.05）.Conclusion Application of laparoscopic cholecystectomy bile duct exploration in the treatment of elderly patients with gallbladder disease complicated with common bile duct stones can achieve good effect,with minimally invasive,less complications,rapid recovery and other advantages,which is worthy of clinical promation and application.