腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石

Laparoscopic Combined with Choledochoscopy for the Treatment of Gallbladder Stones Combined with Common Bile Duct Stones

目的:探讨胆囊结石合并胆总管结石腹腔镜联合胆道镜微创手术的治疗效果。方法:选取胆囊结石合并胆总管结石患者60例,按年限分为两组,两组病例均从往期胆囊结石合并胆总管结石病例中随机筛选,其中2013年1月~2017年12月病例治疗方法为传统开腹治疗,2018年1月~2022年12月采用微创手术治疗,分别为传统手术组和微创手术组,每组各30例。统计分析两组围术期指标、实验室指标、肝功能指标、术后并发症发生情况。结果:微创手术组患者的首次下床时间、肛门排气时间、开始进食时间、输液时间、夹闭T管时间、住院时间均短于传统手术组(P<0.05),补液总量少于传统手术组(P<0.05),住院费用低于传统手术组(P<0.05),白细胞、高敏C反应蛋白、总胆固醇、谷草转氨酶、谷丙转氨酶水平均低于传统手术组(P<0.05),白蛋白水平高于传统手术组(P<0.05),术后并发症发生率低于传统手术组(P<0.05)。结论:胆囊结石合并胆总管结石腹腔镜联合胆道镜微创手术的治疗效果较好。

Objective:To explore the therapeutic effect of laparoscopic combined with choledochoscopy minimally invasive surgery for gallbladder stones and common bile duct stones.Methods:Select 60 patients with gallstones combined with common bile duct stones,divided into two groups according to age,both groups of cases were randomly selected from previous cases of gallbladder stones combined with common bile duct stones.The treatment method for cases from January 2013 to December 2017 was traditional open surgery,and from January 2018 to December 2022,minimally invasive surgery was used.30 cases were randomly selected,namely the traditional surgery group and the minimally invasive surgery group.Retrospective statistical analysis of two groups of perioperative indicators,laboratory indicators,laboratory indicators,liver function indicators,and postoperative complications.Results:The patients in the minimally invasive surgery group had shorter first time out of bed,anal exhaust time,start of eating time,infusion time,T-tube clamping time,and hospitalization time than those in the traditional surgery group(P<0.05).The total amount of fluid replacement was less than that in the traditional surgery group(P<0.05),and the hospitalization cost was lower than that in the traditional surgery group(P<0.05).The levels of WBC,hs CRP,TBIL,AST,and ALT were all lower than those in the traditional surgery group(P<0.05),while the levels of ALB were higher than those in the traditional surgery group(P<0.05).The incidence of postoperative complications was lower than that of the traditional surgery group(P<0.05).Conclusion:The treatment effect of laparoscopic combined with choledochoscopy minimally invasive surgery for gallbladder stones and common bile duct stones is good.