腹腔镜联合胆道镜治疗胆总管结石的疗效与安全性分析

Analysis of clinical effect and safety of laparoscope combined with choledochoscope in the treatment of patients with common bile duct stones

目的探讨腹腔镜联合胆道镜治疗胆总管结石病例的疗效与安全性。方法选择胆总管结石患者98例,采用随机数字表法分为观察组与对照组各49例,分别采用腹腔镜联合胆道镜手术与传统开腹切开胆总管取石术治疗。比较两组的术中、术后指标、并发症与结石复发情况。结果观察组的术中出血量、手术时间优于对照组(P<0.05)。两组的结石取净率差异无统计学意义(P>0.05)。观察组术后24 h疼痛评分、肠鸣音恢复时间、肛门排气时间、平均住院天数和住院费用均优于对照组(P<0.05)。观察组术后并发症发生率(6.12%)低于对照组(20.41%)(P<0.05)。结论腹腔镜联合胆道镜治疗胆总管结石安全有效,值得进一步推广应用。

Objective To probe the clinical effect and safety of laparoscope combined with choledochoscopein the treatment of patients with common bile duct stones. Methods A total of 98 choledocholithiasispatients were selected and randomly divided into the observation group( 49 cases) and the control group( 49 cases). The observation group accepted laparoscope combined with choledochoscopeand when the control groups were given conventional open surgery. Intraoperative and postoperative indicators,complications,and recurrence of stones between twogroups were compared. Results The intraoperative blood loss and time of operation of observation group were superior to those of controls( P < 0. 05). The stone-free rates between twogroups were not statistically significant( P > 0. 05). The postoperative pain score for 24 hours after the surgery,time ofbowel sound recovery,the time of anus exhausting,days of hospitalization and expenses of hospitalization of observation groups were all superior to those of controls( P < 0. 05). The rate of complication of observation groups( 6. 12 %) was lower than that of controls( 20. 41 %)( P < 0.05). Conclusions The laparoscope combined with choledochoscope in the treatment of elderly patients with common bile duct stones issafe and effective,and itdeservesfurther promotion.