胆总管十二指肠大口径低位吻合术治疗老年胆总管结石临床研究

Clinical Study of Choledoch Duodenum of Large Diameter Low Anastomosis in the Treatment of Senile Choledocholithiasis

目的:探讨胆总管十二指肠大口径低位吻合术治疗老年胆总管结石的临床效果。方法:在医院普外科2015年7月～2016年3月期间诊治的老年胆总管结石患者中抽取90例随机分组,对照组(n=45)应用胆管空肠Roux-en-Y吻合术治疗,研究组(n=45)则应用胆总管十二指肠大口径低位吻合术治疗,就两组患者手术指标、复发率以及近远期并发症发生率进行统计学分析。结果:(1)研究组患者的吻合时间、住院时间均短于对照组(P<0.05),术中出血量也少于对照组(P<0.05);(2)研究组患者复发率是2.22%,低于对照组的15.56%(P<0.05);(3)研究组患者近远期并发症发生率是6.67%,同对照组的22.22%相比较低(P<0.05)。结论:胆总管十二指肠大口径低位吻合术治疗老年胆总管结石,可实现有效吻合,且有微创优势,患者康复快,根治性强,近远期并发症较少,值得借鉴。

Objective To investigate the clinical effect of choledoch duodenum of large diameter low anastomosis in the treatment of senile choledocholithiasis. Methods： 90 cases of senile choledocholithiasis treated in general surgery of a hospital from July 2015 to March 2016 were randomly selected and divided.The control group （ n =45） was treated with Roux-en-Y anastomosis thrapy,the research group （ n =45） was treated with choledoch duodenum of large diameter low anastomosis.Operation indicator,the recurrence rate and complication rate of short-long term in 2 groups of patients were statistically analyzed. Results： （1） The anastomosis time and hospitalization time were shorter in the study group than in the control group （ P 〈0.05）, and the intraoperative blood loss was less than that of the control group （ P 〈0.05）.（2） The relapse rate of the study group was 2.22%,lower than the control group with 15.56% （ P 〈0.05）.（3） In the study group, the incidence of short-long term complications was 6.67%,lower than the control group with 22.22% （ P 〈0.05）. Conclusion： Choledoch duodenum of large diameter low anastomosis in the treatment of senile choledocholithiasis can realize effectively anastomose, and has the advantage of minimally invasive, patients recover quickly, has strong eradicative resection, and short-long term complications is few,which is worth learning.