腹腔镜联合输尿管镜治疗胆总管结石的临床疗效

Clinical Efficacy of Laparoscopic Combined with Ureteroscopy in the Treatment of Choledocholithiasis

目的探讨腹腔镜联合输尿管镜治疗胆总管结石的临床疗效。方法选取2016年1月～2018年7月我院治疗的胆总管结石患者68例,按照随机数字表法分为对照组和研究组,各34例。对照组行传统开腹手术治疗,研究组行腹腔镜联合输尿管镜治疗。比较两组手术时间、术中出血量、术后患者肠功能恢复时间、住院时间以及T管拔除时间、结石一次性清除率和术后并发症发生情况。结果两组手术时间比较,差异无统计学意义(P>0.05);研究组术中出血量,术后患者肠道功能恢复时间、住院时间以及T管拔除时间均优于对照组,差异有统计学意义(P<0.05)。研究组结石一次性清除率为91.18%,低于对照组的94.12%,但差异无统计学意义(P>0.05)。研究组术后并发症发生率为5.88%,低于对照组的23.53%,差异有统计学意义(P<0.05)。结论腹腔镜联合输尿管镜治疗胆总管结石,具有创伤小、术中出血量少,术后恢复快及并发症少等优点,同时具有较高的临床应用价值。

Objective To investigate the clinical efficacy of laparoscopic combined with ureteroscopy in the treatment of choledocholithiasis. Methods A total of 68 patients with choledocholithiasis treated in our hospital from January 2016 to July 2018 were enrolled. The patients were divided into the control group and the study group according to the random number table method, 34 cases each. The control group underwent conventional open surgery, and the study group underwent laparoscopic combined with ureteroscopy. The operation time, intraoperative blood loss, postoperative intestinal function recovery time, hospitalization time, T tube removal time, one-time stone removal rate and postoperative complications were compared between the two groups. Results There was no significant difference in the operation time between the two groups (P>0.05).The amount of intraoperative blood loss in the study group, the recovery time of bowel function, hospitalization time and T tube removal time were better than the control group, the difference was statistically significant (P<0.05). The one-time clearance rate of the study group was 91.18%, which was lower than that of the control group 94.12%, but the difference was not statistically significant (P>0.05). The incidence of postoperative complications in the study group was 5.88%, which was lower than that in the control group 23.53%,the difference was statistically significant (P<0.05). Conclusion Laparoscopic combined with ureteroscopy for the treatment of choledocholithiasis has the advantages of small trauma, less intraoperative blood loss, quick postoperative recovery and less complications, and has high clinical value.