腹腔镜胆囊切除术联合胆总管切开取石T管引流术治疗胆囊合并胆总管结石的效果观察

Efficacy of LC combined with LCHTD ongallstone patients complicated with choledocholithiasis

目的:探讨腹腔镜胆囊切除术联合胆总管切开取石T管引流术(LC+LCHTD)在胆囊合并胆总管结石治疗中的临床效果。方法:选取60例胆囊合并胆总管结石患者,按照治疗方式的不同分为两组。对照组30例,采用传统开放胆囊切除术联合胆总管切开取石T管引流术(OC+OCHTD)治疗,观察组30例,采用腹腔镜胆囊切除术联合胆总管切开取石T管引流术(LC+LCHTD)治疗,对比两组的治疗效果。结果:观察组术中出血量少于对照组,住院时间短于对照组(P<0.05);观察组住院费用高于对照组(P<0.05);两组术后不同时间点疼痛程度(VAS)评分比较,观察组均低于对照组,两组比较差异有统计学意义(P<0.05);观察组患者ALB下降幅度明显小于对照组(P<0.05),WBC、TBIL下降幅度比较差异无统计学意义(P>0.05);观察组并发症发生率明显低于对照组(P<0.05)。结论:LC联合LCHTD治疗胆囊合并胆总管结石患者效果理想,且安全性较高。

Objective:To investigate the effects of LC combined with LCHTD in the treatment of gallstone patients complicated with choledocholithiasis.Methods:60 patients with choledocholithiasis were divided into 2 groups according to the different methods of treatment,30 patients in the control group received conventional open cholecystectomy plus choledocholithotomy and T-tube drainage(OC+OCHTD)treatment,while another 30 patients in the observation group underwent laparoscopic cholecystectomy plus laparoscopic choledocholithotomy and T-tube drainage(LC+LCHTD)treatment.Then the treatment effect of two groups were compared.Results:The intraoperative blood loss and length of hospital stays of the observation group was less than that of the control group(P<0.05);the cost of hospitalization was higher than that of the control group(P<0.05);VAS score of postoperative pain at different time points was lower than that of the control group,which was of statistical difference(P<0.05);ALB in the observation group decreased less than that of the control group(P<0.05);there was no statistical significance of WBC and TBIL in the decrease range(P>0.05);and the incidence of complications in observation group was significantly lower than that in control group(P<0.05).Conclusion:LC combined with LCHTD is effective and safe in the treatment of gallstone patients with cholecystolithiasis.