腹腔镜联合十二指肠镜及胆道镜在胆囊结石合并胆总管结石治疗中的应用

Application of Laparoscopy Combined with Duodenoscope and Choledochoscopein the Treatment of Gallstones and Common Bile Duct Stones

目的观察腹腔镜、胆道镜及十二指肠镜联合应用对胆囊结石合并胆总管结石的治疗效果。方法选择2017年6月~2019年2月在我院治疗的胆囊结石合并胆总管结石患者108例,采用随机数字表法分为观察组和对照组,各54例。对照组采用腹腔镜和十二指肠镜治疗,观察组在对照组基础上加用胆道镜治疗,比较两组临床结石完全清除率、手术指标、并发症发生情况。结果观察组结石完全清除率为100.00%,高于对照组的87.03%(P<0.05);观察组手术时间、术中出血量、术后肛门排气时间、住院时间均少于对照组(P<0.05);观察组并发症发生率为3.70%,低于对照组的14.81%(P<0.05)。结论腹腔镜、胆道镜及十二指肠镜联合应用治疗胆囊结石合并胆总管结石的完全结石清除率高,且手术时间短,术中出血量少,术后胃肠功能恢复快,并术后并发症低,疗效确切。

Objective To observe the therapeutic effect of combined application of laparoscopy,choledochoscope and duodenoscope on gallstones and common bile duct stones.Methods A total of 108 patients with gallstones and common bile duct stones treated in our hospital from June 2017 to February 2019 were selected and divided into observation group and control group by random number table method,with 54 cases in each group.The control group was treated with laparoscopy and duodenoscope,and the observation group added choledochoscope on the basis of the control group.The clinical stone complete removal rate,surgical index,and complications were compared between the two groups.Results The complete stone removal rate in the observation group was 100.00%,which was higher than 87.03%in the control group(P<0.05);The operation time,intraoperative blood loss,postoperative anal exhaust time,and hospitalization time of the observation group were all less than that of the control group(P<0.05);the incidence of complications in the observation group was 3.70%,lower than that of the control 14.81%(P<0.05).Conclusion The combined application of laparoscopy,choledochoscopy and duodenoscopy for the treatment of gallstones and common bile duct stones has a high complete stone clearance rate,short operation time,less intraoperative bleeding,and rapid recovery of gastrointestinal function after surgery The complication is low and the curative effect is definite.