腹腔镜与胆道镜联合治疗胆囊结石合并肝外胆管结石的临床疗效观察

Clinical observation of laparoscopic surgery combined with intraoperative bile duct endoscopy in the treatment of patients with gallbladder stones and extrahepatic bile duct stones

目的探讨腹腔镜与术中胆道镜联合治疗胆囊结石并肝外胆管结石患者的临床疗效。方法选取82例胆囊结石合并肝外胆管结石患者作为本次研究的对象,经随机数字表法将其随机分为观察组与对照组,观察组行腹腔镜与胆道镜联合手术治疗,对照组行开腹手术治疗。比较两组的临床指标、并发症、结石清除及复发情况。结果观察组术中出血量、住院时间以及术后肛门排气时间均少于对照组(P<0.05),而手术时间比较两组差异无统计学意义(P>0.05);观察组术后并发症总发生率显著低于对照组(14.6 vs 36.6%,P<0.05);两组结石清除率均为100%,观察组术后1年复发率低于对照组比较差异无统计学意义(2.4%vs 7.3%,P>0.05)。结论腹腔镜联合胆道镜治疗胆囊结石合并肝外胆管结石具有创伤小、患者恢复快等优势,能够显著减少并发症的发生率,值得临床推广。

ObjectiveTo explore the clinical efficacy of laparoscopy combined with intraoperative biliary endoscopy in the treatment of gallbladder stones with extrahepatic bile duct stones.MethodsEighty two cases of cholecystolithiasis and extrahepatic bile duct stones were selected as the research objects by randomly assigned into observation group and control group.The observation group underwent surgery combining laparoscopy and choledochoscopy in treatment,while the control group underwent open surgery.The clinical indexes,complications,stone clearance and recurrence of the two groups were compared.ResultsThe amount of bleeding,hospitalization time and postoperative anal exhaust time in the observation group were less than the control group(P<0.05),yet there was no significant difference in operation time between the two groups(P>0.05).Postoperative complications in the observation group was significantly lower than that of the control group(146%vs36.6%,P<0.05).The stone clearance rate was100%in both groups.There was no significant difference in1year recurrence rate between the two groups(2.4%vs7.3%,P>0.05).ConclusionsLaparoscopy combined with bile duct endoscopy in the treatment of gallbladder stones with extrahepatic bile duct stones has advantages of small trauma,rapid recovery of patients,which can significantly reduce the incidence of complications with the value in the clinical promotion.