腹腔镜结合胆道镜保胆取石术与腹腔镜胆囊切除术治疗胆囊结石的临床效果比较

Analysis of curative effect and safety of laparoscopy combined with choledochoscopy in treatment of gallstones

目的比较腹腔镜结合胆道镜保胆取石术与腹腔镜胆囊切除术治疗胆囊结石的临床效果。方法选取该院2014-03~2016-04收治的胆囊结石患者100例,根据手术实施方法的不同分为观察组(实施腹腔镜结合胆道镜保胆取石术)及对照组(实施腹腔镜胆囊切除术),各50例。比较两组手术疗效及安全性。结果观察组术中出血量、术后24 h疼痛评分及住院时间均低于对照组,术后并发症发生率低于对照组,差异有统计学意义(P <0. 05);术后12个月观察组胆囊收缩功能及胆囊壁厚度较术前显著改善,差异有统计学意义(P <0. 05)。结论腹腔镜结合胆道镜保胆取石术治疗胆囊结石临床效果较腹腔镜胆囊切除术好,患者术中出血量少,住院时间短,术后并发症少,且术后胆囊功能明显改善,安全可靠。

Objective To analyze the efficacy and safety of laparoscopy combined with choledochoscopy in treatment of gallstones. Methods 100 patients with cholecystolithiasis admitted to our hospital from March 2014 to April 2016 were divided into the observation group（treated with laparoscopy combined with choledochoscopy, n=50） and the control group（treated with laparoscopy, n=50） according to different operative methods. The surgical efficacy and safety were compared between the two groups. Results The intraoperative blood loss, postoperative 24 h pain scores and hospitalization time in the observation group were significantly lower or shorter than those in the control group. The incidence of postoperative complications in the observation group was lower than that in the control group（P〈0.05）. The gallbladder contraction function and thickness of gallbladder wall in the observation group improved significantly after the operation（P〈0.05）. Conclusion Laparoscopy combined with choledochoscopy is safer and more effective than laparoscopic cholecystectomy for the patients with gallstones. Laparoscopy combined with choledochoscopy can shorten the time of hospitalization, reduce the postoperative complications, and improve the postoperative gallbladder function.