腹腔镜胆道探查取石T管引流术术式的研究

Study of laparoscopic procedure for remove of common bile duct stone and T-tube drainage

目的 探讨腹腔镜胆总管探查取石的最佳手术方法及手术适应证。方法 对我中心实施12 4例腹腔镜胆囊切除与胆总管切开探查取石、T管引流术的临床资料进行分析。结果 82例改进术式 ,中转开腹 4例 (4 .9% ) ,平均手术时间 (80± 3 0 )min。常规术式 42例 ,中转开腹 6例 (14 .3 % ) ,平均手术时间 (170± 40 )min。改进术式在手术时间上明显缩短于常规术式 (P <0 .0 1) ;中转开腹率显著低于常规术式 (P <0 .0 5 )。疗效和住院日两者无明显差异。结论 改进后的胆总管切开探查取石、T管引流术是治疗胆总管结石更为安全有效的措施。

Objective To study the optimal laparoscopic procedure and its indication for remove of common bile duct stone. Methods Analysis was made on the clmical data of 124 cases of laparoscopic choledocholithotomy and T tube drainage in our center.Results 82 patients underwent the improved laparoscopic procedure, alternation to open operation in 4 cases (4.9%),and the mean operating time was (80±30) min. While 42 patients were operated with traditional laparoscopic method,changing to open operation in 6 cases (14.3%),and the mean operating time was (170±40) min . The improved method could shorten the operation time and reduce the open operation rate significantly than traditional method did (P<0.05). However,the two methods showed no significant difference in the effect and time of hospital stuy. Conclusions The improved laparoscopic procedure for remove of common bile duct stone and T tube drainage is a safe and effective method.