腹腔镜联合胆道镜治疗肝内外胆管结石的安全性及疗效

The safety and efficacy of laparoscopy combined with choledochoscopy in the treatment of intrahepatic and extrahepatic bile duct stones

目的:探究肝内外胆管结石患者采用腹腔镜联合胆道镜的治疗效果与安全性。方法:选择220例肝内外胆管结石患者,并根据治疗方法的不同分为两组,两组分别予以开腹手术治疗(对照组)、腹腔镜联合胆道镜治疗(观察组),比较两组患者的手术时间、住院时间、术中出血量与并发症情况。结果:观察组术中出血量、手术时间及住院时间都少于对照组,差异有统计学意义(P<0.05);观察组患者胆漏发生率、结石残留发生率、胆道出血发生率、胆道感染发生率、总并发症发生率分别为0.91%、0%、0%、0%、0.91%,均低于对照组的7.27%、12.73%、7.27%、10%、37.27%,差异有统计学意义(P<0.05)。结论:肝内外胆管结石患者采用腹腔镜联合胆道镜的治疗效果显著,并发症发生率较低。

Objective To explore the efficacy and safety of laparoscopy combined with choledochoscopy in the liver of patients with bile duct stones. Method A total of 220 cases of hepatolithiasis patients were selected,according to the different treatment methods,They were divided into 2 groups,2 groups were given open abdominal surgery,laparoscopy combined with choledochoscopy in treatment,respectrvely. The operation time,hospital time,amount of bleeding and complications during operation of the patients in two groups were compared. Results The bleeding of the observation group during the operation,the operation time and hospitalization time were less than the control group,there were statistical significance（P〈0. 05）; the observation group of patients with bile leakage rate,The incidence of residual stones,incidence of biliary tract bleeding,the incidence of biliary tract infection,the total complication rate was 0. 91%,0%,0%,0%,0. 91%,were lower than the control group 7. 27%,12. 73%,7. 27%,10%,37. 27%,respectively,there were statistical significance（P〈0. 05）. Conclusion Patients with extrahepatic bile duct stones by laparoscopy combined with choledochoscopy the significant curative effect,low incidence of complications.