腹腔镜胆总管切开取石术在有上腹部手术史患者中的应用

Application of laparoscopic choledocholithotomy on patients with previous upper abdominal surgery history

目的探讨腹腔镜胆总管切开取石术在有上腹部手术史患者中的应用。方法有上腹部手术史的胆总管结石患者134例,76例患者行腹腔镜胆总管切开取石术(腹腔镜组),58例患者行开腹胆总管切开取石术(开腹组),比较两组患者手术时间、术中出血量、术后并发症及住院时间。结果腹腔镜组术中出血量和住院时间少于开腹组[(94.3±22.8)ml vs.(157.2±34.8)ml和(6.4±2.5)d vs.(11.4±3.7)d](P<0.01或P<0.05),两组手术时间和术后并发症发生率差异无统计学意义(P>0.05)。结论腹腔镜胆总管切开取石术治疗有上腹部手术史的胆总管结石患者安全、有效。

Objective To investigate the application of laparoscopic choledocholithotomy in the patients with a previous history of upper abdominal surgery. Methods A total of 134 cases of choledocholithiasis with a previous history of upper abdominal surgery was divided into two groups. Group A （76 cases） was treated with laparoscopic choledocholithotomy and group B （58 cases） was treated with laparotomic choledocholithotomy. The operation time, blood loss, postoperative complications and hospital stay were compared between two groups. Results The blood loss and hospital stay were less in group A than those in group B（94. 3±22. 8） ml vs. （157. 26±34. 8） ml and （6.4±2.5） days vs. （11.4± 63.7） days] （P〈0.01 and P〈0.05）. There were no significant differences in operation time and postoperative complications between two groups （P〈0. 05 ）. Conclusion Laparoscopic choledocholithotomy is safe and effective in the patients of choledocholithiasis with a previous history of upper abdominal surgery.