腹腔镜联合胆道镜微创保胆取石术治疗胆石症的效果

Therapeutic effect of laparoscopic combined with choledochoscopic gallbladder-preserving minimally invasive cholecystolithotomy on cholelithiasis

目的研究腹腔镜联合胆道镜微创保胆取石术治疗胆石症的效果。方法抽取2020年5月至2022年5月南阳市第一人民医院收治的胆石症患者66例,按照随机数字表法分为对照组与研究组,每组33例。对照组采用腹腔镜胆囊切除术治疗,研究组采用腹腔镜联合胆道镜微创保胆取石术治疗。比较两组围术期指标(手术时间、术中出血量、住院时间)、术后恢复情况(肛门首次排气时间、肛门首次排便时间、肠蠕动恢复时间)、胆囊壁厚度、胆囊收缩率及并发症发生率。结果与对照组比较,研究组手术时间较长,术中出血量较少,住院时间较短(P<0.05)。研究组术后肛门首次排气时间、肛门首次排便时间、肠蠕动恢复时间短于对照组(P<0.05)。术后12周,研究组胆囊壁厚度小于对照组,胆囊收缩率大于对照组(P<0.05)。研究组并发症发生率(3.03%,1/33)低于对照组(24.24%,8/33),差异有统计学意义(P<0.05)。结论腹腔镜联合胆道镜微创保胆取石术治疗胆石症效果较好,能减少术中出血量,缩短住院时间,有利于促进胆囊收缩和术后机能恢复,且治疗安全性高。

Objective To study the effect of laparoscopic combined with choledochoscopic gallbladder-preserving minimally invasive cholecystolithotomy in the treatment of cholelithiasis.Methods A total of 66 patients with cholelithiasis treated in Nanyang First People’s Hospital from May 2020 to May 2022 were selected,and they were divided into control group and study group by random number table method,with 33 cases in each group.The control group was treated by laparoscopic cholecystectomy,and the study group was treated by laparoscopic combined with choledochoscopic gallbladder-preserving minimally invasive cholecystolithotomy.Perioperative indexes(operation time,intraoperative blood loss volume,hospital stay),postoperative recovery condition(the first anal exhaust time,the first anal defecation time,intestinal peristalsis recovery time),gallbladder wall thickness,gallbladder contraction rate,and incidence of complication of the two groups were compared.Results Compared with the control group,the study group had longer operation time,less intraoperative blood loss and shorter hospital stay(P<0.05).Compared with the control group,the first anal exhaust time,the first anal defecation time and intestinal peristalsis recovery time of the study group were shorter after surgery(P<0.05).Compared with the control group,the study group had smaller gallbladder wall thickness and higher gallbladder contraction rate 12 weeks after operation(P<0.05).The incidence of complications of the study group(3.03%,1/33)was lower than that of the control group(24.24%,8/33),and the difference was significant(P<0.05).Conclusions Laparoscopic combined with choledochoscopic gallbladder-preserving minimally invasive cholecystolithotomy is effective in the treatment of cholelithiasis,which can reduce intraoperative blood loss,shorten hospital stay,promote gallbladder contraction and postoperative recovery of various functions,with high safety.