腹腔镜联合胆道镜微创取石术治疗胆囊结石合并胆囊息肉临床研究

Laparoscopic cholecystectomy combined with minimally invasive cholecystectomy in the treatment of gallbladder polyps

目的:探讨腹腔镜联合胆道镜微创取石术治疗胆囊结石合并胆囊息肉患者的临床疗效。方法:选取胆囊结石合并胆囊息肉的患者60例,分为观察组和对照组各30例,对照组采用纤维胆道镜取石手术进行治疗,观察组采用腹腔镜联合胆道镜微创取石术治疗,对两组患者的手术情况(手术时间、术后下床活动时间、住院时间、术中出血量、肛门排气时间、止痛药物使用剂量和术后消化功能评分)和术后并发症的发生情况进行观察比较。结果:观察组患者的手术时间、术后下床活动时间、住院时间、术中出血量、肛门排气时间和止痛药物的使用剂量均显著低于或小于对照组,而术后消化功能评分显著高于对照组(P<0.05),观察组的并发症发生率为6.67%,显著低于对照组30.00%(P<0.05)。结论:采用腹腔镜联合胆道镜微创取石术治疗胆囊结石合并胆囊息肉,患者治疗效果后,术后并发症发生情况低,具有很高的安全性。

Objective:To investigate the indications,effects and complications of laparoscopic cholecystectomy combined with minimally invasive choledochoscopy in the treatment of gallbladder stones combined with gallbladder polyps.Method:60 patients with cholecystolithiasis and gallbladder polyps treated in third department of surgery of friendship hospital of Shaanxi from June 2013 to February 2017 were divided into observation group(30 cases)and control group(30 cases).The control group was treated by fibrocholedochoscopy Laparoscopic cholecystectomy,while the cases of the observation group were treated with laparoscopic cholecystectomy with minimally invasive lithotomy.The operative conditions(operation time,ambulation time after surgery,hospital stay,intraoperative blood loss,anal exhaust time,dosage of analgesic drugs and postoperative digestion Functional score)and postoperative complications were observed and compared.Results:The operation time,postoperative ambulation time,hospitalization time,intraoperative blood loss,anal exhaust time and the dosage of analgesic drugs in the observation group were significantly lower than those in the control group,and postoperative digestive function scores were significantly higher than the control group(P<0.05).The complication rate in the observation group was 6.67%,which was significantly lower than that in the control group(30.00%)(P<0.05).Conclusion:Laparoscopic combined cholecystolithiasis minimally invasive lithotomy in the treatment of gallbladder stones with gallbladder polyps,the patient's treatment effect,the incidence of postoperative complications is low,the surgery has high safety,it is worthy of clinical promotion and application.