腹腔镜手术中纤维胆道镜经胆囊管胆道探查取石术治疗胆总管结石的效果观察

Effects of laparoscopic transcystic common bile duct exploration and stone extraction on patients with choledocholithiasis

目的观察腹腔镜手术中纤维胆道镜经胆囊管胆道探查取石术对胆总管结石患者的临床疗效。方法选取2014年1月至2018年12月北京京煤集团总医院与舞阳县人民医院收治的90例胆总管结石患者为研究对象,经随机数字表法分为研究组与对照组,每组45例。研究组行腹腔镜手术中纤维胆道镜经胆囊管胆道探查取石术治疗,对照组行腹腔镜胆囊切除+胆总管切开取石+T管引流术治疗。记录并比较两组手术时间、术后住院时间、治疗费及术后并发症发生情况。结果两组胆总管结石患者均顺利完成相应手术治疗,手术成功率均为100.00%。研究组术后住院时间、治疗费用均少于对照组(P均<0.05);两组手术时间比较差异未见统计学意义(P>0.05)。研究组术后并发症发生率(2.22%)低于对照组(15.56%),P<0.05。结论胆总管结石患者经腹腔镜手术中纤维胆道镜经胆囊管胆道探查取石术治疗效果较优,有利于保障其预后及生活质量。

Objective To observe the clinical effects of laparoscopic transcystic common bile duct exploration and stone extraction on patients with choledocholithiasis. Methods Ninety patients with choledocholithiasis admitted to Beijing Jingmei Group General Hospital and Wuyang People’s Hospital from January 2014 to December 2018 were selected as the study subjects. The patients were divided into study group and control group by random number table method, with 45 cases in each group. The study group underwent laparoscopic surgery with laparoscopic transcystic common bile duct exploration and stone extraction. The control group underwent laparoscopic choledocholithotomy and T-tube drainage. The operation time, postoperative hospital stay, treatment expenses and incidence of complications were recorded and compared between the two groups. Results All the patients with choledocholithiasis successfully completed the corresponding surgery, and the success rate of the operation was 100.00%. The postoperative hospital stay and treatment expenses were lower in the study group than those in the control group (P<0.05). There was no significant difference in operation time between the two groups (P>0.05). Study group had lower incidence of postoperative complications (2.22%) than control group (15.56%), P<0.05. Conclusions Laparoscopic surgery with laparoscopic transcystic common bile duct exploration and stone extraction for patients with choledocholithiasis has better treatment effects, which is beneficial to ensuring the prognosis and quality of life.