腹腔镜联合胆道镜治疗肝外胆管结石并一期缝合 158例临床分 析简

目的 对腹腔镜联合胆道镜（LCBDE）并一期缝合治疗158例肝外胆管结石的手术治疗效果进行分析.方法 回顾性分析广州军区总医院2008年9月～2012年7月158例肝外胆管结石行开腹手术的患者作为对照组,选择同期158例患者行LCBDE并一期缝合治疗肝外胆管结石的临床资料为观察组;对比两组患者的治愈率及并发症发生率.结果 观察组治愈148例,治愈率为93.67％,好转6例,4例中转开腹.对照组治愈123例,治愈率为77.85％,观察组治愈率高于对照组,差异有统计学意义（P＜0.05）.观察组结石残留4例,残留率为2.53％,对照组结石残留35例,残留率为22.15％,观察组并发症发生率（4.43％）明显低于对照组的并发症发生率（23.42％）,差异有统计学意义（P＜0.05）.结论 LCBDE治疗肝外胆管结石并一期缝合给患者造成创伤小,治愈率得到很大提高,术后恢复快且并发症少.

Clinical analysis of laparoscopic common bile duct exploration with primary suture for calculi of extrahepatic bile duct in 158 cases

Objective To study the clinical analysis of laparoscopic common bile duct exploration （LCBDE） with primary suture for calculi of extrahepatic bile duct in 158 cases.Methods From September 2008 to July 2012 in the Guangzhou Military General Hospital,158 cases of extrahepatic bile duct stones underwent traditional laparotomy were chosen as control group; at the same time another 158 cases clinical data with extrahepatic bile duct stones treated with LCBDE combined with primary suture were selected as the observation group; and patients cured rate and complication rate of two groups were compared carefully.Results In observation group,148 cases were cured and the cure rate was 93.67%,6 cases were improved and 4 cases were converted to laparotomy; while in control group,123 cases were cured and the cure rate was 77.85%; the cure rate in observation group was higher than that in control group,the difference was statistically significant （P 〈 0.05）.In observation group,4 cases appeared calculi residual and residual rate was 2.53%.In control group appeared 35 cases calculi residual; residual rate was 22.15% and the complication rate of observation group was 4.43%.In control group,the complication rate was 23.42%.The complication rate of observation group was compared with that of control group,the differences were statistically significant （P 〈 0.05）.Conclusion Patients of extrahepatic bile duct stones treated with LCBDE combined with primary suture have smaller trauma,higher rate of cure,less complications compared with patients treated with traditional laparotomy.