腹腔镜下胆总管切开取石术治疗胆总管结石的效果观察

Curative effect of laparoscopic choledocholithotomy on choledocholithiasis

目的探讨腹腔镜下胆总管切开取石术治疗胆总管结石的临床效果。方法选取2015年6月至2017年6月于五四一总医院接受治疗的60例胆总管结石患者,采取随机数字表法分为观察组和对照组,每组30例。对照组采取开腹胆囊切除胆总管切开取石术治疗,观察组采取腹腔镜下胆总管切开取石术。比较两组手术相关指标、应激反应指标及并发症发生情况。结果观察组出血量、术后镇痛次数、并发症发生率少于对照组,且胃肠道功能恢复时间、住院时间短于对照组(P<0.05)。术后,对照组血清皮质醇水平、游离三碘甲状腺原氨酸水平与观察组比较差异有统计学意义(P<0.05)。结论腹腔镜下胆总管切开取石术对患者创伤更小,应激反应更轻,术后并发症更少,具有推广价值。

Objective To investigate the curative effect of laparoscopic choledocholithotomy on choledocholithiasis. Methods Sixty patients with choledocholithiasis who were treated in 541 General Hospital from June 2015 to June 2017 were enrolled and divided into two groups according to random number table method. In control group, 30 patients underwent open cholecystectomy and choledocholithotomy. In observation group, 30 patients underwent laparoscopic choledocholithotomy. Related operation indexes, stress response indexes and incidence of complication were compared between the two groups. Results The bleeding volume, postoperative analgesia, and incidence of complication in observation group were significantly lower than those in control group, and the recovery time and hospitalization time of the gastrointestinal function were shorter than those in control group (P<0.05). After operation, serum cortisol levels and free triiodothyronine (FT3) levels were significantly different between control group and observation group (P<0.05). Conclusions Laparoscopic choledocholithotomy for patients with choledocholithiasis has less trauma, stress response and postoperative complications, which has a promotional value.