应用腹腔镜联合胆道镜手术治疗胆囊结石伴胆总管结石的疗效观察

Observation on the efficacy of laparoscopic combined with choledochoscopy surgery for the treatment of gallbladder stones with common bile duct stones

目的:探析胆囊合并胆总管结石应用腹腔镜联合胆道镜手术治疗价值。方法:纳入2020年2月至2023年1月间本院收治拟行胆道镜手术治疗胆囊结石伴胆总管结石患者80例为研究对象,以患者所制定手术治疗方案为准,分设组别,其中对照组行开腹手术治疗,观察组应用腹腔镜十胆道镜手术,各组有40例。从两组手术方式患者的围术期指标、手术安全性、恢复质量方面评价其临床价值。结果:手术耗费时间方面,观察组患者相对更长,术后肛门排气、导尿管放置、住院时间比较,观察组更短,术中出血量更少(P<0.05)。机体应激状态方面,术后两组患者心率、血压、皮质醇、肾上腺素均有提升,观察组患者术后上述应激指标检测低于对照组,差异有统计学意义(P<0.05)。手术随访提示两组患者机体免疫指标数据检测存在显著统计差异(P<0.05)。术后观察组患者发生手术相关并发症例数低于对照组,有统计学意义(P<0.05)。结论:腹腔镜十胆道镜应用于临床收治胆囊合并胆总管结石患者,在疗效及安全性方面均满足临床预期。

Objective:To explore the value of laparoscopic combined with choledochoscopy surgery for the treatment of gallblad-der combined with common bile duct stones.Methods:Eighty patients with cholecystolithiasis and choledocholithiasis who were admitted to Jinxiang County People's Hospital from February 2020 to January 2023 for surgical treatment were included as the objects of analysis.The patients were divided into groups according to the surgical treatment plan formulated for the pa-tients.The control group was treated with open surgery,and the observation group was treated with laparoscopy+choledocho-scopy,with 40 cases in each group.Evaluate the clinical value of the two groups of surgical methods in terms of perioperative indicators,surgical safety,and recovery quality.Results:The operation time of patients in the observation group was relative-ly longer,the postoperative anal exhaust,catheter placement and hospital stay were shorter,and the intraoperative blood loss was less(P<0.05).In terms of body stress state,the heart rate,blood pressure,cortisol and adrenaline of the two groups were all increased after surgery,and the above stress indexes of the observation group were lower than those of the control group,with statistical significance(P<0.05).The postoperative follow-up indicated that there were significant statistical differences in the detection of immune indexes between the two groups(P<0.05).The number of surgery-related complica-tions in the observation group was lower than that in the control group,with statistical significance(P<o.05).Conclusion:The application of laparoscopy and choledochoscopy in clinical treatment of patients with gallbladder and common bile duct in-terpretation meets clinical expectations in terms of efficacy and safety.