胆囊结石应用腹腔镜胆囊切除术与保胆取石术治疗的价值对照研究

Comparative study of laparoscopic cholecystectomy and gallbladder preserving lithotomy for cholecystolithiasis

目的分析胆囊结石应用腹腔镜胆囊切除术与保胆取石术治疗的价值。方法 200例胆囊结石患者根据住院编号奇偶分为切除胆囊组与保胆组,各100例。切除胆囊组应用腹腔镜胆囊切除术,保胆组应用保胆取石术治疗。比较两组胆囊结石一次取净率、手术时间、失血量、术后肠蠕动时间、住院时间以及并发症发生率。结果保胆组胆囊结石一次取净率为95.00%与切除胆囊组的96.00%比较,差异无统计学意义(P>0.05)。保胆组消化不良、胆汁返流、腹胀腹泻并发症发生率为3.00%,明显低于切除胆囊组的15.00%,差异具有统计学意义(P<0.05)。保胆组手术时间、失血量、术后肠蠕动时间、住院时间均明显少于切除胆囊组,差异具有统计学意义(P<0.05)。结论胆囊结石应用腹腔镜胆囊切除术与保胆取石术治疗均可取净结石,但保胆取石术治疗创伤更小,操作更简单,可避免切除胆囊后消化不良、胆汁返流、腹泻等并发症的发生,加速术后肠蠕动,缩短康复时间。

Objective To analyze the value of laparoscopic cholecystectomy and gallbladder preservinglithotomy for cholecystolithiasis.Methods A total of200cholecystolithiasis patients were divided by hospitalnumber parity into gallbladder resection group and gallbladder preserving group,with100cases in eachgroup.The gallbladder resection group received laparoscopic cholecystectomy,and the gallbladder preservinggroup received gallbladder preserving lithotomy for treatment.Comparison were made on primary cleaningrate of gallbladder,operation time,bleeding volume,postoperative intestinal peristalsis,hospitalization time,and incidence of complications in two groups.Results The gallbladder preserving group had no statisticallysignificant difference in primary cleaning rate of gallbladder as95.00%,comparing with96.00%in the gallbladderresection group(P>0.05).The gallbladder preserving group had obviously lower incidence of complications ofindigestion,bile reflux,bloating diarrhea as3.00%than15.00%in the gallbladder resection group,and thedifference had statistical significance(P<0.05).The gallbladder preserving group had less operation time,bleedingvolume,postoperative peristalsis time and hospitalization time than the gallbladder resection group,and thedifference had statistical significance(P<0.05).Conclusion Both laparoscopic cholecystectomy and gallbladderpreserving lithotomy can clear cholecystolithiasis,but gallbladder preserving lithotomy has less trauma andsimpler operation.It can avoid the occurrence of complications such as cholecystectomy,indigestion,bile reflux,diarrhea,and accelerate the postoperative peristalsis and shorten the recovery time.