腹腔镜与开腹左肝外叶切除联合胆道镜治疗左肝管内结石的疗效比较

Comparison of Laparoscopic and Open Left Lateral Lobectomy with Choledochoscopy in the Treatment of Calculus in Left Hepatic Duct

目的比较腹腔镜与开腹左肝外叶切除联合胆道镜治疗左肝管内结石的疗效。方法选择2015年10月至2016年10月本医院接诊的左肝管内结石患者50例,随机分为对照组和观察组,每组25例,对照组患者接受开腹左肝外叶切除术联合胆道镜取石术,观察组患者接受腹腔镜左肝外叶切除术联合胆道镜取石术,比较两组治疗效果。结果观察组术后下床活动时间、肠功能恢复时间、住院时间及术后疼痛评分均显著低于对照组(P <0.05);观察组并发症发生率比对照组并发症发生率显著更低(P <0.05);两组在术后结石残留率、1年复发率上比较差异无统计学意义(P <0.05)。结论腹腔镜手术治疗左肝管内结石疗效确切,患者术后疼痛轻,恢复快,并发症发生率低。

Objective To compare the efficacy of laparoscopic left lateral hepatectomy and open choledochoscopy in the treatment of left hepatic duct stones.Methods 50 patients with left hepatic duct stones were randomly divided into the control group and the observation group,with 25 cases in each group.The control group received open left hepatic lobectomy combined with choledochoscopy,and the patients in the observation group received laparoscopic left hepatic lobectomy combined with choledochoscopy.The therapeutic effects of both groups were compared.Results The time of ambulation,the recovery time of intestinal function,the time of hospitalization and postoperative pain score in the observation group were significantly lower than those in the control group(P<0.05),and the incidence of complications in the observation group was significantly lower than that of the control group(P<0.05).There was no statistical difference between the two groups in the residual rate of stone and the recurrence rate of 1 years after operation.Conclusion Laparoscopic surgery is effective in the treatment of left hepatic duct stones,with less postoperative pain,faster recovery and lower incidence of complications.