不同术式治疗胆囊结石合并胆总管结石的效果比较

Comparison of Different Surgical Treatment of Gallbladder Combined with Common Bile Duct Calculi

目的比较腹腔镜胆道探查术(LCBDE)、常规开腹胆道探查T管引流术治疗胆囊结石合并胆总管结石的效果和安全性。方法整群选取2010年11月—2014年11月期间该院收治的42例胆囊结石合并胆总管结石行常规开腹胆道探查T管引流术患者作为开腹组,选取43例胆囊结石合并胆总管结石行LCBDE术患者作为LCBDE组,对比手术效果。结果LCBDE组手术切口平均长度(3.12±1.53)cm、术后并发症2.33%、手术平均时间(96.31±26.43)min、术后通气平均时间(1.22±0.43)min分别低于开腹组(11.63±1.69)cm,、19.05%、(121.39±26.87)min、(3.12±0.45)min,P<0.05。结论LCBDE书在缩小手术切口、降低术后并发症、缩短手术时间和术后通气时间等方面优于开腹组,值得临床对手术方法继续探讨和研究。

Objective To compare the efficacy and safety between laparoscopic common bile duct exploration surgery(LCBDE)and conventional open bile duct exploration and T-tube drainage in the treatment of gallbladder combined with common bile duct stones. Methods 42 patients with gallbladder combined with common bile duct stones undergoing conventional open bile duct exploration and T-tube drainage between November 2010 and November 2014 were assigned to open group, and other 43 patients undergoing LCBDE in the same period were assigned to LCBDE group. The outcomes were compared. Results The average length of incision [(3.12 ± 1.53) cm vs(11.63 ± 1.69) cm], postoperative complications(2.33% vs 19.05%), average operation time [(96.31± 26.43) min vs(121.39 ± 26.87) min], and mean postoperative ventilation time [(1.22 ± 0.43) min vs(3.12 ± 0.45) min] were all lower in the LCBDE group than in the open group,P <0.05. Conclusion To conventional open bile duct exploration and T-tube drainage, CLBDE is superior in reducing incision length, postoperative complications, operative time and postoperative ventilation time, therefore it is worthy of further research.