不同手术方式治疗胆总管结石的临床效果

Clinical effect of different surgical methods for the treatment ofcommon bile duct stones

目的比较胆总管结石行两种手术方式治疗的临床效果。方法回顾性分析2015年1月至2019年9月滨州医学院附属医院收治的244例胆总管结石患者的临床资料。所有患者均行手术治疗,其中144例患者行腹腔镜下胆总管切开取石手术治疗(实验组),100例患者行传统的开腹胆总管切开取石手术治疗(对照组)。分析比较两组患者的术中情况及术后并发症情况。单因素分析采用logistic回归分析,Spearman相关系数被用来检验实验组与对照组和其他实验室数据的相关性。结果两组比较术中出血量、肛门排气时间、住院时间、手术时间、切口感染等差异均有统计学意义(P<0.05);胆瘘、腹腔感染等术后并发症差异无统计学意义。结论腹腔镜下胆总管切开取石术较传统的开腹胆总管切开取石术治疗胆总管结石可有效缩短手术时间,减少术中失血及术后并发症。具有创伤小、住院时间短及并发症少等优势,值得在广大医院尤其是基层医院进行推广。

Objective To compare the clinical effects of two surgical methods for the treatment of common bile duct stones.Methods The clinical data of 244 patients with common bile duct stones admitted to Binzhou Medical University Hospital in Shandong Province from January to September 2019 were retrospectively analyzed.All patients underwent surgery.Among them,144 patients underwent laparoscopic common bile duct stone removal(the experimental group),and 100 patients underwent conventional open choledocholithotomy(the control group).The intraoperative and postoperative complications of the two groups were compared and analyzed.Univariate analysis was performed using logistic regression analysis,and the Spearman correlation coefficient was used to test the correlation between the experimental group and the control group and other laboratory data.Results Intraoperative blood loss,anal exhaust time,hospitalization time,operation time and incision infection were statistically significant between the two groups.Postoperative complications such as bi-liary fistula and abdominal infection were not statistically significant.Conclusion Laparoscopic common bile duct incision and stone removal compared with conventional open bile duct incision and stone removal for common bile duct stones can effectively shorten the operation time and reduce intraoperative blood loss and postoperative complications.It has the advantages of small trauma,short hospitalization days and less complications,and it is worthy of promotion in hospitals,especially in primary hospitals.