胆总管结石采用腹腔镜联合胆道镜治疗的临床疗效及并发症影响

Clinical Effect and Complication of Choledocholithiasis Treated by Laparoscopy Combined with Choledochoscope

目的 探讨采用腹腔镜联合胆道镜治疗胆总管结石的临床疗效及并发症。方法 随机选择2018年1月—2021年6月福建中医药大学附属南平人民医院收治的60例胆总管结石患者为研究对象,随机分为对照组和观察组,每组30例。观察组患者采用腹腔镜联合胆道镜治疗,对照组患者采用同期行开腹胆囊切除+胆总管切开取石。比较两组胆总管结石患者的临床疗效、手术情况、并发症发生情况及术后残留率。结果 观察组患者的总有效率为96.67%,略高于对照组的86.67%,但差异无统计学意义(χ^(2)=0.873,P=0.350)。两组患者的手术时间、术中出血量、排气时间、住院时间比较,差异有统计学意义(P<0.05)。观察组患者并发症发生率为13.33%,低于对照组的50.00%,差异有统计学意义(χ^(2)=9.320,P=0.002)。两组患者切口感染率比较,差异有统计学意义(P<0.05)。两组患者术后的结石残留率比较,差异无统计学意义(P>0.05)。结论 采用腹腔镜联合胆道镜治疗的胆总管结石患者可提高患者的临床效果,降低术后并发症发生率。

Objective To investigate the clinical effect and complications of choledocholithiasis treated by laparoscopy combined with choledochoscope.Methods Sixty patients with choledocholithiasis admitted to Nanping People´s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2018 to June 2021 were random selected as the study objects,and were randomly divided into control group and observation group,with thirty patients in each group.Patients with choledocholithiasis in the observation group were treated with laparoscopy combined with choledochoscope,while patients in the control group were treated with open cholecystectomy plus choledocholithotomy at the same time.The clinical efficacy,surgery,complications of choledocholithiasis and postoperative residual rate were compared between the two groups.Results The total effective rate of the observation group was 96.67%,which was slightly higher than 86.67%of the control group,but the difference was not statistically significant(χ^(2)=0.873,P=0.350).There were statistically significant differences in operation time,intraoperative blood loss,exhaust time and hospital stay between the two groups(P<0.05).The incidence of complications in the observation group was 13.33%lower than that in the control group(50.00%),and the difference was statistically significant(χ^(2)=9.320,P=0.002).Compared the incision infection rate between the two groups,the difference was statistically significant between the two groups(P<0.05).There was no statistically significant difference in postoperative stone residual rate between the two groups(P>0.05).Conclusion Laparoscopy combined choledochoscope can improve the clinical effect of patients with choledocholithiasis and reduce the incidence of postoperative complications.