保留Oddi括约肌功能的三镜联合治疗胆囊结石合并胆总管结石108例临床研究

Clinical study on the treatment of 108 cases of cholecystolithiasis combined with common bile duct stones with Oddi sphincter preserving function

目的 :对胆囊结石合并胆总管结石患者采取保留Oddi括约肌功能的三镜联合治疗方案治疗的临床疗效进行评价。方法:收集2012年7月—2016年4月期间,我院收治的胆囊结石合并胆总管结石的患者108例作为本次的受试对象,根据手术方法进行分组为A、B、C三组,其中A组给予十二指肠镜联合腹腔镜手术治疗,B组给予腹腔镜联合胆道镜手术治疗,C组给予内镜下鼻胆管引流术、腹腔镜胆总管探查术、腹腔镜胆囊切除术联合手术治疗,治疗后,将不同组别患者治疗后的效果进行比较。结果 :A组和B组患者的手术时间及术后在院内进行康复的时间相近,且均较C组患者短,差异均有统计学意义(P<0.05);内镜下鼻胆管引流术+腹腔镜胆总管探查术+腹腔镜胆囊切除术引起术后患者并发症发生的概率显著低于A组和B组,差异有统计学意义(P<0.05)。结论 :内镜下鼻胆管引流术+腹腔镜胆总管探查术+腹腔镜胆囊切除术用于胆囊结石合并胆总管结石患者的治疗,可以保留Oddi括约肌功能,降低患者术后并发症的发生,安全性高,建议临床推广。

Objective: To clinical curative effect of combined three mirror retention function of sphincter of Oddi treatment to evaluate patients with cholecystolithiasis and choledocholithiasis. Methods: During the period from July 2012 to April 2016, 108 patients in our hospital were cholecystolithiasis with common bile duct stones as the subjects, were randomly divided into A, B, C three groups, A group was given duodenoscopy combined with laparoscopic surgery, B group received laparoscopic surgery treatment. C group received endoscopic nasobiliary drainage, laparoscopic choledochotomy and laparoscopic cholecystectomy combined with surgical treatment, after treatment, the treatment group patients after the effects were compared. Results: rehabilitation in hospital operation time of A group and B group of patients and the postoperative time is near, and were higher than those in group C were shorter, the differences were There was statistical significance(P < 0.05); endoscopic nasobiliary drainage caused by the probability of occurrence of postoperative complications was significantly lower than that in A group and B group were resection + laparoscopic choledochotomy + laparoscopic cholecystectomy, the difference was statistically significant(P < 0.05). Conclusion: Endoscopic nasobiliary drainage for the treatment of patients with gallbladder stones combined with common bile duct stones surgery resection + laparoscopic choledochotomy + laparoscopic cholecystectomy, can keep the function of sphincter of Oddi, reduce the incidence of postoperative complications, high safety, worthy of clinical promotion.