腹腔镜胆道探查术治疗肝外胆管结石的疗效

Curative Effect Of Laparoscopic Biliary Exploration in Treatment Of Extrahepatic Bile Duct Stones

目的研究三种不同方式腹腔镜胆道探查术治疗肝外胆管结石的疗效及其临床应用价值。方法选取2018年11月至2019年11月我院收治的肝外胆管结石患者96例,按照随机数字分组法将其随机分为A、B、C三组,每组32例。A组行腹腔镜胆囊切除术+经胆囊管胆道镜探查术治疗,B组行腹腔镜胆囊切除术+胆总管切开探查术+胆管一期缝合术治疗,C组行腹腔镜胆囊切除术+胆总管切开探查术+T管引流术治疗。统计并比较三组患者的手术时间、住院时间、腹腔引流时间、恢复正常时间等相关临床指标。结果在手术时间、腹腔引流时间、住院时间、恢复正常生活时间等各项指标中,A组均短于B、C组,B组均短于C组,差异有统计学意义(P<0.05)。结论在肝外胆管结石的治疗中,腹腔镜胆囊切除术+经胆囊管胆道镜探查术总体疗效最为理想,其次是腹腔镜胆囊切除术+胆总管切开探查术+胆管一期缝合术,在实际的治疗中,要结合患者的病情进行合理的选择。

Objective To study effect and clinical application value of three different methods of laparoscopic biliary exploration in treatment of extrahepatic bile duct stones.Methods We chose 96 cases of extrahepatic bile duct stones patients admitted to our hospital from November 2018 to November 2019,divided them into three groups randomly,A,B,and C,with 32 cases in each group.Group A was treated with laparoscopic cholecystectomy + transcystic choledochoscopy,group B with laparoscopic cholecystectomy + common bile duct exploration + primary bile duct suture treatment,group C with laparoscopic cholecystectomy + common bile duct incision and exploration + T tube drainage treatment.We made the statistical comparison between three groups on operation time,length of stay,abdominal drainage time,time returning to normal and other related clinical indicators.Results Various indicators of operation time,abdominal drainage time,hospital stay,and normal life time in group A were shorter than those of group B and C,those of group B were shorter than those of group C,difference was statistically significant (P<0.05).Conclusion In treatment of extrahepatic bile duct stones,laparoscopic cholecystectomy + cystic duct choledochoscopy has the best overall curative effect,followed by laparoscopic cholecystectomy + common bile duct exploration + primary bile duct suture.In actual treatment,it is necessary to choose reasonable scheme based on patient’s condition.