十二指肠镜联合腹腔镜治疗胆囊胆管结石分析

Analysis of Duodenoscope Combined with Laparoscopy in the Treatment of Gallbladder and Bile Duct Stones

目的探讨对胆囊胆管结石患者采取十二指肠镜联合腹腔镜治疗的效果。方法2018年4月—2019年4月期间为纳入时间,选择该院就诊的胆囊胆管结石患者70例,依照计算机表法分组,每组35例。对参照组行开腹手术,将胆囊切除,并将肝外胆管切开取石;对实验组行十二指肠镜联合腹腔镜治疗。检验两组胆囊胆管结石患者的切口长度、手术时间、术中出血量、首次离床活动时间、腹腔引流时间、术后进食时间、胃肠道功能恢复时间、并发症发生率。结果实验组胆囊胆管结石患者的切口长度(2.84±1.02)cm、手术时间为(76.42±13.16)min、术中出血量为(57.48±10.85)mL、首次离床活动时间为(11.42±3.42)h、腹腔引流时间为(1.73±0.65)d、术后进食时间为(1.81±0.68)d、胃肠道功能恢复时间为(2.06±0.83)d,优于参照组,差异有统计学意义(t=26.077、9.656、9.540、24.441、7.426、8.019、10.586,P<0.05);实验组胆囊胆管结石患者的并发症发生率为8.57%(3/35),低于参照组28.57%(10/35),差异有统计学意义(χ^(2)=4.629,P<0.05)。结论对胆囊胆管结石患者采取十二指肠镜联合腹腔镜治疗,其是一种微创技术,具有不开刀、恢复快的优点,临床各项指标恢复显著,有效地控制并发症发生,其实用性和安全性均较高,临床应用价值较高。

Objective To explore the effect of duodenoscope combined with laparoscopy on patients with gallbladder stones.Methods From April 2018 to April 2019 as the time of enrollment,70 patients with gallbladder stones who were admitted to the hospital were divided into groups according to the computer table method,with 35 cases in each group.Laparotomy was performed on the reference group,the gallbladder was removed,and the extrahepatic bile duct was incised to remove stones;the experimental group was treated by duodenoscope combined with laparoscopy.The length of incision,operation time,intraoperative blood loss,first out of bed time,abdominal drainage time,postoperative eating time,gastrointestinal function recovery time,and complication rate of the two groups of patients with gallbladder stones were tested.Results In the experimental group,the incision length of the patients with gallbladder stones was(2.84±1.02)cm,the operation time was(76.42±13.16)min,the intraoperative blood loss was(57.48±10.85)mL,and the first out of bed time was(11.42±3.42)h,the Abdominal drainage time was(1.73±0.65)d,postoperative eating time was(1.81±0.68)d,the gastrointestinal function recovery time was(2.06±0.83)d,which was better than the reference group,the difference was statistically significant(t=26.077,9.656,9.540,24.441,7.426,8.019,10.586,P<0.05);the complication rate of patients with gallbladder stones in the experimental group was 8.57%(3/35),which was lower than the reference group 28.57%(10/35),the difference was statistically significant(χ^(2)=4.629,P<0.05).Conclusion Duodenoscope combined with laparoscopy is a minimally invasive technique for patients with gallbladder and bile duct stones.It has the advantages of no surgery and quick recovery.The clinical indicators have recovered significantly,and the occurrence of complications can be effectively controlled.Practicability and safety are high,and clinical application value is high.