腹腔镜联合胆道镜治疗胆囊并胆总管结石的效果

Effect of Laparoscopy Combined with Choledochoscopy for Gallbladder and Common Bile Duct Stones

目的比较腹腔镜联合胆道镜与传统手术治疗胆囊并胆总管结石的临床疗效和经济性。方法回顾性选取2016年2月—2019年2月马鞍山十七冶医院普外科收治的胆囊结石合并胆总管结石患者60例的临床资料,随机分为两组。腹腔镜联合胆道镜组(简称双镜组)30例,开腹手术组(简称开腹组)30例。比较两组患者临床疗效和经济性。结果双镜组手术时间(176.87±61.23)min长于开腹组(101.57±37.11)min,差异有统计学意义(t=5.761,P<0.05);与开腹组相比,双镜组患者失血量、术后下床时间、术后住院时间、住院费用少,差异有统计学意义(t=14.723、7.529、5.298、3.814,P<0.05)。两组患者并发症发生率比较,差异无统计学意义(χ^(2)=1.670,P>0.05)。结论腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石是可行和安全可靠方法,有术后恢复快、手术费用低等优势。

Objective To compare the clinical efficacy and economy of laparoscopy combined with choledochoscopy with traditional surgery for gallbladder and common bile duct stones.Methods From February 2016 to February 2019,the clinical data of 60 patients with gallbladder stones combined with common bile duct stones admitted to the general surgery department of Maanshan Shiqiyei Hospital were retrospective selected and randomly divided into two groups,30 cases were treated with laparoscopy combined with choledochoscopy(referred to as the dual-scope group)and 30 cases were treated with open surgery(referred to as the open abdominal group).The clinical efficacy and economy of the patients in the two groups were compared.Results The operation time was(176.87±61.23)min in the dual-scope group,longer than(101.57±37.11)min in the open abdominal group,and the difference was statistically significant(t=5.761,P<0.05).Patients in the dual-scope group had less bleeding,postoperative bed discharge time,postoperative hospitalization time and lower hospitalization cost,and the difference was statistically significant(t=14.723,7.529,5.298,3.814,P<0.05).There was no statistically significant difference between the complication rates of the two groups(χ^(2)=1.670,P>0.05).Conclusion Laparoscopy combined with choledochoscopy is a feasible and safe and reliable method for the treatment of gallbladder stones combined with common bile duct stones,with the advantages of rapid postoperative recovery and low surgical cost.