输尿管镜代替胆道镜行腹腔镜胆总管切开取石术的效果分析

Effect of laparoscopic choledocholithotomy with ureteroscope instead of choledochoscope

目的:观察输尿管镜代替胆道镜行腹腔镜胆总管切开取石术的临床效果。方法:将胆总管结石患者60例按随机数字表法分为观察组(n=30)和对照组(n=30)。观察组给予输尿管镜+腹腔镜胆总管切开取石术治疗,对照组给予胆道镜+腹腔镜胆总管切开取石术治疗。比较两组手术总有效率、手术情况及术后恢复情况。结果:观察组手术总有效率高于对照组;手术时间、术后住院时间及术后肛门排气时间、引流管拔除时间及首次下床时间均短于对照组,术中出血量少于对照组;术后7 d血清TBIL、AST、ALT水平及VAS评分均低于对照组,术后并发症发生率低于对照组(均P<0.05)。结论:将输尿管镜应用于腹腔镜胆总管切开取石术中,可提高结石取尽率,缩短手术时间及术后住院时间,并且可促进术后肝功能恢复。

Objective:To observe the clinical effect of laparoscopic choledocholithotomy with ureteroscope instead of choledochoscope.Methods:Sixty patients with choledocholithiasis were randomly divided into an observation group(n=30)and a control group(n=30).The observation group underwent ureteroscope plus laparoscopic choledocholithotomy,while the control group underwent choledochoscope plus laparoscopic choledocholithotomy.Operation overall response rate,operation condition and postoperative recovery were compared between the two groups.Results:The overall response rate was higher,the times for operation,hospital stay,postoperative anal exhaust,drainage tube extraction and the first time out of bed were shorter and the levels of serum TBIL,AST,ALT,the scores of VAS on the 7th day after operation and the incidence of postoperative complications were lower in the observation group than the control group(all P<0.05).Conclusion:The application of ureteroscope in laparoscopic choledocholithotomy can increase stone-free rate,shorten the times for operation and postoperative hospitalization and promote the recovery of postoperative liver function.