腹腔镜胆囊切除联合内镜逆行胆管取石治疗胆囊结石合并继发胆总管结石的临床研究

[目的]探讨腹腔镜胆囊切除联合内镜逆行胆管取石治疗胆囊结石合并继发胆总管结石的临床疗效。[方法]选取2008年6月～2011年6月于某院进行治疗的88例胆囊结石合并继发胆总管结石患者为研究对象,将其随机分为对照组(开腹手术组)44例和观察组(腹腔镜胆囊切除联合内镜逆行胆管取石术组)44例,后将两组患者的手术成功率、排气时间、住院时间、并发症发生率、患者满意率及术前1d、术后1d、3d及7d的血清IL-1β、IL-6、IL-8、TNF-α及hs-CRP水平进行统计及比较。[结果]观察组的排气时间、住院时间均短于对照组,并发症发生率低于对照组,患者满意率高于对照组,术后1d、3d及7d的血清IL-1β、IL-6、IL-8、TNF-α及hs-CRP水平均低于对照组,P均﹤0.05,差异均有统计学意义,而两组患者手术成功率差异无统计学意义,P﹥0.05。[结论]腹腔镜胆囊切除联合内镜逆行胆管取石治疗胆囊结石合并继发胆总管结石的临床疗效较好,安全性也较高,并且可以抑制患者的炎性反应。

THE CLINICAL STUDY ON THE LAPAROSCOPIC CHOLECYSTECTOMY COMBINED WITH ENDOSCOPIC RETROGRADE BILE DUCT DRAINAGE DUCT STONES IN GALLSTONE AND SECONDARY CHOLEDOCHOLITH

[Objective]To study the clinical effect of laparoscopic cholecystectomy combined with endoscopic retrograde bile duct drainage duct stones in gallstone and secondary choledocholith.[Methods]88 patients with gallstone and secondary choledocholit in our hospital from June 2008 to June 2011 were selected,and they were randomly divided into control group(open surgery group)with 44 cases and observation group(combined with endoscopic retrograde bile duct drainage duct stones group)with 44 cases.Then we analyzed and compared the success rate of operation,exhaust time,hospitalization time,incidence of complications,patients’ satisfaction rate and serum IL-1β,IL-6,IL-8,TNF-α and hs-CRP before and after the surgery at first,third and seventh day of two groups.[Results]The exhaust time and hospitalization time of observation group were shorter than those of control group,incidence of complications was lower than that of control group,patients’ satisfaction rate was higher than that of control group,and serum IL-1β,IL-6,IL-8,TNF-α and hs-CRP after the surgery at first,third and seventh day were lower than those of control group(all P﹤0.05).Significant difference was found in the two groups.There was no significant difference between the success rate of operation of the two groups,P﹥0.05.[Conclusion]The clinical effect of laparoscopic cholecystectomy combined with endoscopic retrograde bile duct drainage duct stones in gallstone and secondary choledocholith was better and had high safety,and can inhibit the inflammatory reaction of patients.