腹腔镜手术治疗胆总管结石合并胆囊结石的临床研究

Clinical Study on Laparoscopic Surgery for Treating Choledocholithiasis Combined with Cholecystolithiasis

目的:探讨腹腔镜和开腹手术治疗胆总管结石合并胆囊结石的疗效,分析腹腔镜手术的临床价值。方法:选取2017年1月-2022年1月江苏省阜宁县人民医院收治的100例胆总管结石合并胆囊结石患者作为研究对象,根据患者病情结合患者意愿,将采用开腹手术治疗的患者纳入开腹组,腹腔镜治疗的患者纳入腹腔镜组,各50例。开腹组患者采用传统开腹胆囊切除术联合胆道探查取石术治疗,腹腔镜组患者采用腹腔镜胆囊切除术联合胆道探查取石术治疗。观察两组患者手术指标、术后6 h及24 h疼痛评分、手术成功率及并发症发生率。结果:两组患者手术切口长度、手术耗时、术中出血量、术后排气时间及住院时间比较,腹腔镜组均明显优于开腹组,差异有统计学意义(P<0.05)。两组患者术后6 h、24 h疼痛评分比较,腹腔镜组显著低于开腹组,差异有统计学意义(P<0.05)。两组患者手术均成功,腹腔镜组并发症发生率低于开腹组,差异有统计学意义(P<0.05)。结论:与传统开腹手术相比较,腹腔镜手术具有创伤小、并发症少、术后疼痛轻、恢复快等优点,是治疗胆总管结石合并胆囊结石安全有效的手术方法,值得推广。

Objective:To explore the efficacy of laparoscopic surgery and laparotomy in the treatment of choledocholithiasis complicated with cholecystolithiasis,and analyze the clinical value of laparoscopic surgery.Methods:A total of 100 patients with choledocholithiasis complicated with cholecystolithiasis admitted to Funing County People's Hospital in Jiangsu Province from January 2017 to January 2022 were selected as the study subjects were selected.According to the patient's condition and patient's wishes,patients treated with laparotomy were included into laparotomy group,and patients treated with laparoscopic surgery were included into laparoscopy group.Each group contained 50 patients.Patients in the laparotomy group were given traditional laparotomy cholecystectomy combined with bile duct exploration lithotomy,and patients in the laparoscopy group were given laparoscopic cholecystectomy combined with bile duct exploration lithotomy.The surgical indexes,pain scores at postoperative 6 hours and 24 hours,surgery success rate and complication rate of the two groups were observed.Results:The length of surgical incision,operation time,intraoperative blood loss,postoperative exhaust time and hospital stay in the laparoscopy group were significantly better than those in the laparotomy group,with statistically significant differences(P<0.05).The pain scores at postoperative 6 hours and 24 hours in the laparoscopy group were significantly lower than those in the laparotomy group,with statistically significant differences(P<0.05).The surgery was successful in both groups,and the complication rate in the laparoscopy group was lower than those in the laparotomy group,with statistically significant differences(P<0.05).Conclusion:Compared with traditional laparotomy surgery,laparoscopic surgery has the advantages of less trauma,fewer complications,mild postoperative pain,and quick recovery.It is a safe and effective surgical method for treating choledocholithiasis combined with cholecystolithiasis,and it is worth popularizing.