常规开腹手术与腹腔镜联合胆道镜治疗肝胆总管结石合并胆囊结石的效果对比

Comparison on Effects of Conventional Laparotomy and Laparoscopy Combined with Choledochoscopy in the Treatment of Common Bile Duct Stones Complicated with Cholecystolithiasis

目的探讨腹腔镜联合胆道镜治疗肝胆总管结石合并胆囊结石的价值。方法选取我院收治的74例肝胆总管结石合并胆囊结石患者,随机分为对照组和观察组各37例。对照组行常规开腹手术,观察组行腹腔镜联合胆道镜治疗。对比两组患者的手术相关指标、术后使用止痛药及并发症情况。结果两组患者的手术时间和住院费用比较均无统计学差异(P>0.05)。观察组的出血量、切口长度、肛门排气恢复时间、术后下床时间、住院时间均优于对照组(P <0.05)。观察组术后止痛药使用率和并发症发生率均低于对照组(P <0.05)。结论采用腹腔镜联合胆道镜治疗肝胆总管结石合并胆囊结石的效果显著,能够促进患者恢复,减少术后并发症。

Objective To study the value of laparoscopy combined with choledochoscopy in the treatment of common bile duct stones complicated with cholecystolithiasis. Methods 74 cases of patients with common bile duct stones complicated with cholecystolithiasis admitted to our hospital were selected and randomly divided into control group and observation group, with 37 cases in each group. The control group received conventional laparotomy, while the observation group received laparoscopy combined with choledochoscopy. The operation-related indicators, postoperative analgesics and complications were compared between the two groups. Results No statistical difference was found in the operation time and hospitalization expenses between two groups（P 0.05）. The blood loss, incision length, anal exhaust recovery time, postoperative out-of-bed time and hospitalization time of the observation group were better than those of the control group（P 0.05）. The use rate of postoperative analgesics and incidence of complications of the observation group were lower than those of the control group（P 0.05）. Conclusions Laparoscopy combined with choledochoscopy in the treatment of common bile duct stones combined with cholecystolithiasis has significant effect, which can promote the recovery of patients, and reduce postoperative complications.