腹腔镜胆总管切开取石T管引流术与开腹手术治疗肝胆管结石的疗效对比

Comparison of laparoscopic choledocholithotomy combined with T-tube drainage and laparotomy in the treatment of hepatolithiasis

目的:研究腹腔镜胆总管切开取石T管引流术(LCHTD)治疗肝胆管结石的疗效。方法:选取肝胆管结石且行手术治疗的患者100例,按手术方法不同分为观察组(n=40)和对照组(n=60)。对照组行传统开腹手术,观察组行LCHTD。比较两组患者手术情况和术后恢复情况,手术前后总胆红素(TBIL)、结合胆红素(CB)、非结合胆红素(UCB)、胃肠病生活质量指数(GIQLI)及术后不良反应发生情况。结果:观察组手术用时、术中出血量、术后排气和进食用时低于对照组(P<0.05);术后观察组TBIL、CB、UCB水平低于对照组(P<0.05),GIQLI各维度得分及总分高于对照组(P<0.05);术后不良反应发生率低于对照组(P>0.05)。结论:腹腔镜胆总管切开取石T管引流术可缩短手术进程,减少术中损伤,调节胆红素代谢,提高患者生活质量,整体疗效较理想且安全性高。

Objective:To study the curative effect of laparoscopic choledocholithotomy combined with T-tube drainage(LCHTD)on hepatolithiasis.Methods:100 patients with hepatolithiasis were retrospectively selected and divided into observation group and control group according to different surgical methods.The control group received traditional laparotomy,with 60 cases.The observation group received LCHTD in 40 cases.The operation and postoperative recovery,the levels of total bilirubin(TBIL),conjugated bilirubin(CB),unconjugated bilirubin(UCB)and gastrointestinal quality of life index(GIQLI)before and after operation and the incidence of postoperative adverse reactions were compared between the two groups.Results:The operation time,intraoperative blood loss,postoperative exhaust and eating time in the observation group were significantly lower than those in the control group(P<0.05).The levels of TBIL,CB and UCB after operation were significantly lower than those in the control group(P<0.05).The scores and total scores of GIQLI after operation were significantly higher than those of the control group(P<0.05).The incidence of postoperative adverse reactions was significantly lower than that of the control group(P>0.05).Conclusion:Laparoscopic choledocholithotomy combined with T-tube drainage can shorten the operation process,reduce intraoperative injury,regulate bilirubin metabolism,and improve patients'quality of life.The overall curative effect is ideal with higher safety.