PTCSL与LD治疗胆总管结石的近中期随访比较

Comparison of PTCSL and LD in the treatment of choledocholithiasis in the near and mid-term follow-up

目的分析经皮肝胆管穿刺碎石取石术(PTCSL)与腹腔镜胆总管切开取石术(LD)治疗胆总管结石的近中期疗效。方法回顾性分析2017年1月至2019年6月期间94例单纯胆总管结石患者的临床资料,按不同治疗方式分为两组,PTCSL组和LD组,每组47例。采用SPSS23.0软件进行处理,手术相关指标以(-x±s)表示,独立样本t检验;一次结石排净率、并发症发生率、胆总管结石复发率用百分比表示,用χ^(2)检验或Fisher精确检验。P<0.05为差异有统计学意义。结果PTCSL组患者术后手术时间、术后排气时间、下床活动时间、住院时间短于LD组(P<0.05);两组患者术后1年、2年、3年内结石复发率及一次结石排净率、术后并发症发生率比较,差异均无统计学意义(P>0.05)。结论PTCSL与LD具有相似的一次性结石排净率,术后并发症均较少,但PTCSL手术时间更短,更利于术后早恢复。

Objective To analyze the short-and medium-term efficacy of percutaneous transhepatic cholelithotomy(PTCSL)and laparoscopic choledocholithotomy(LD).Methods The clinical data of 94 patients with simple choledocholithiasis from January 2017 to June 2019 were retrospectively analyzed.They were divided into two groups according to different treatment methods,PTCSL group and LD group,with 47 patients in each group.SPSS23.0 software was used for processing,and the operative indicators were expressed as(-x±s),independent t test was used.The one stone elimination rate,complication rate,and common bile duct stone recurrence rate were expressed in percentage,byχ^(2)test or Fisher s accurate test.P<0.05 was considered statistically significant.Results The operation time,postoperative exhaust time,ambulation time and hospital stay of PTCSL group were shorter than those of LD group(P<0.05).There was no significant difference in stone recurrence rate,stone removal rate and postoperative complication rate between the two groups within 1,2 and 3 years after surgery(P>0.05).Conclusion PTCSL and LD have similar one-time stone removal rate and fewer postoperative complications,but PTCSL has shorter operation time and is more conducive to early postoperative recovery.