胆道镜联合腹腔镜经胆囊管探查治疗胆管结石的临床效果

Curative effect of choledochoscope combined with laparoscopic cholecystic duct exploration in the treatment of bile duct calculus

目的探讨胆道镜联合腹腔镜经胆囊管探查治疗胆管结石的临床效果。方法回顾性选取2019年8月至2021年7月苏州市第九人民医院肝胆外科收治的121例胆囊合并胆总管结石患者作为研究对象,按照手术方式分为观察组(60例)与对照组(61例)。观察组采用腹腔镜下胆囊切除联合经胆囊管胆管探查取石术,对照组采用腹腔镜下胆囊切除+胆总管切开取石+T管引流术,比较两组病例围手术期及术后并发症情况。结果观察组术后带管时间、排气时间及住院时间均短于对照组,差异有统计学意义(P<0.05)。两组病例手术时间、出血量及术后并发症比较,差异无统计学意义(P>0.05)。结论腹腔镜下胆囊切除联合经胆囊管胆管探查取石术可行有效,可避免胆管切开后T管引流,显著缩短患者术后带管时间及住院天数。

Objective To investigate the efficacy of choledochoscope combined with laparoscopic cholecystic duct exploration in the treatment of bile duct calculus.Methods A total of 121 patients with gallbladder complicated with choledocholithiasis admitted to the Department of Hepatobiliary Surgery of Suzhou Ninth People′s Hospital from August 2019 to July 2021 were retrospectively selected as the subjects,according to the operation method,they were divided into observation group(60 cases)and control group(61 cases).The observation group adopted laparoscopic trans-cystic duct common bile duct exploration,the control group adopted the laparoscopic common bile duct exploration.The cases of perioperative and postoperative complications were compared between the two groups.Results The postoperative catheter time,exhaust time and postoperative hospital stay in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).There were no statistical differences in operation time,blood loss and postoperative complications between the two groups(P>0.05).Conclusion Laparoscopic cholecystectomy combined with cholecystectomy and cholecystectomy is feasible and effective,which can avoid T tube drainage after cholecystectomy,and significantly shorten postoperative catheter time and hospital stay.