PTCS术与传统手术治疗复发性胆管结石60例临床分析

Clinical analysis of 60 cases of recurrent cholangiolithiasis treated by PTCS and traditional surgery

目的探讨在复发性胆管结石的治疗中经皮经肝胆道镜取石术(PTCS)和传统手术方案的治疗优势。方法选取右江民族医学院附属医院肝胆外科所收治的复发性胆管结石患者60例,随机分成两组。治疗实验组患者采用PTCS术式治疗,对照组患者采用传统术式治疗。对两组患者的疗效评估包含术中出血量、术后结石残余率、术后并发症发生比例、手术全程耗时、术后肛门排气恢复时间、疼痛等级。结果与对照组相比,治疗实验组患者手术出血量减少(P<0.05)、手术时间明显缩短(P<0.05)、结石残余率降低(P<0.05);治疗实验组患者术后肛门排气恢复时间明显缩短(P<0.05),术后第1天术口疼痛程度轻(P<0.05)。结论PTCS术与传统手术方案相比具有安全、可行,操作简单,取净结实率高的特点,在临床应用中能够发现患者创伤小、康复快、并发症少的优势,在肝胆外科微创治疗的工作中具有一定的推广空间。

Objective To explore the advantages of percutaneous transhepatic choledochoscopy(PTCS)and traditional surgery in the treatment of recurrent cholangiolithiasis.Methods 60 patients with recurrent cholangiolithiasis treated in the Department of Hepatobiliary Surgery of The Affiliated Hospital of Youjiang Medical University for Nationalities were randomly divided into two groups.The patients in the treatment group were treated with PTCS,while the patients in the control group were treated with traditional surgery.The efficacy was evaluated by observing intraoperative blood loss,postoperative stone residual rate,the proportion of postoperative complications,the duration of operation,the recovery time of postoperative anal exhaust,and the level of pain.Results Compared with the control group,the treatment group had a less amount of intraoperative blood loss,obviously shorter duration of operation and lower residual rate of stones(P<0.05).The recovery time of anal exhaust in the treatment group significantly shortened(P<0.05),and the degree of pain on the first day after surgery was relieved(P<0.05).Conclusion Compared with traditional surgery,PTCS is characterized by safety,feasibility,simple operation and high rate of removing calculi.It is found in clinical application that it has the advantages of fewer traumas,quick recovery and less complications,with certain promotion value in the minimally invasive treatment for hepatobiliary surgery.