腹腔镜、胆道镜及十二指肠镜联合治疗肝外胆管结石的效果

Effect of combination of laparoscopy, choledochoscopy and duodenoscopy in the treatment of extrahepatic bile duct stones

目的探讨腹腔镜、胆道镜及十二指肠镜联合治疗肝外胆管结石的效果。方法将我院收治的102例肝外胆管结石患者按照手术方式分为对照组和观察组,各51例。对照组采用腹腔镜治疗,观察组应用腹腔镜、胆道镜及十二指肠镜联合治疗。比较两组的治疗效果。结果术后3d,观察组MTL、CCK、CEA、CA19-9水平均优于对照组(P<0.05)。两组胆道压力于术后1d升高,术后3d下降,但差异无统计学意义(P>0.05)。术后3个月,观察组GLQI评分高于对照组(P<0.05)。结论腹腔镜、胆道镜及十二指肠镜联合治疗肝外胆管结石能有效降低CEA、CA19-9、CCK水平,对MTL的影响小,且不会引起胆道压力骤升,值得临床推广。

Objective To explore the effect of combination of laparoscopy, choledochoscopy and duodenoscopy in the treatment of extrahepatic bile duct stones. Methods A total of 102 patients with extrahepatic bile duct stones admitted in our hospital were divided into control group and observation group according to the way of operation, with 51 cases in each group. The control group was treated with laparoscopy, while the observation group was treated with combination of laparoscopy, choledochoscopy and duodenoscopy. The therapeutic effects of the two groups were compared. Results At 3 days after operation, the levels of MTL, CCK, CEA and CA19-9 in the observation group were better than those in the control group (P<0.05). Biliary tract pressure increased at 1 day after operation and decreased at 3 days after operation, but there were no significant differences (P>0.05). At 3 months after operation, the GLQI score of the observation group was higher than that of the control group (P<0.05). Conclusion Combination of laparoscopy, choledochoscopy and duodenoscopy in the treatment of extrahepatic bile duct stones can effectively reduce the levels of CEA, CA19-9 and CCK, with less influence on MTL, and do not cause sudden rise of biliary tract pressure, which is worthy of clinical promotion.