腹腔镜联合胆道镜治疗复杂性胆囊结石效果观察

Observation on effect of laparoscopy combined with cholangioscopy on complicated gallstone

目的评价腹腔镜联合胆道镜治疗复杂性胆囊结石的临床效果。方法整体筛查法选取信阳市眼科医院2016年3月至2018年3月收治的复杂性胆囊炎患者96例,随机双盲法分为两组各48例,对照组应用单纯腹腔镜手术治疗,观察组给予腹腔镜联合胆道镜治疗。比较两组患者手术治疗效果。结果观察组一次性结石取净率95.83%,二次手术发生率4.17%;对照组一次性结石取净率72.92%,二次手术发生率27.08%,组间对比差异有统计学意义(P<0.05);两组患者术中出血量比较差异无统计学意义(P>0.05),观察组肛门排气时间、下床活动时间、腹痛消失时间及住院时间较对照组缩短,有统计学意义(P<0.05);对照组并发症发生率20.83%,观察组并发症发生率4.17%,差异有统计学意义(P<0.05)。结论腹腔镜联合胆道镜治疗复杂性胆囊结石效果显著,患者术后恢复速度快,临床价值高。

Objective To evaluate the clinical effect of laparoscopy combined with cholangioscopy in the treatment of complicated gallstone. Methods The overall selection screening method from March 2016 to March 2016 were the complexity of the 96 cases of cholecystitis patient,double-blind method is divided into two groups at random,48 cases in the control group used pure laparoscopic surgery,observation group was given laparoscopic joint choledochoscope therapy. Surgical treatment was compared between the two groups. Results In the observation group,the net rate of one-time calculus removal was 95. 83%,and the rate of secondary surgery was 4. 17%. In the control group,the net rate of one-time calculus removal was 72. 92%,and the rate of secondary surgery was 27. 08%. The difference between the two groups was statistically significant（ P〈 0. 05）. Bleeding amount of two groups of patients there was no statistical significance（ P〈 0. 05） difference comparison,observation group anal exhaust time,ambulation time,abdominal pain disappeared time and hospital stay were shorter,there was statistically significant（ P〈 0. 05）; The complication rate of the control group was 20. 83%,and that of the observation group was 4. 17%. The difference was statistically significant（ P〈 0. 05）. Conclusion Laparoscopy combined with cholangioscopy is effective in the treatment of complicated cholecystolithiasis.