腹腔镜联合胆道镜治疗胆总管结石56例临床分析

目的 评价腹腔镜联合纤维胆道镜治疗胆总管结石的临床疗效.方法 回顾性对比分析腹腔镜联合胆道镜手术组（n=56）与开腹手术组（n=56）胆总管探查取石术的手术时间、术中出血量、术后排气恢复时间、术后住院天数、术后疼痛率、并发症发生率等指标.结果 腹腔镜联合胆道镜手术组的手术操作时间与开腹手术组差异无统计学意义（P＞0.05）;术中出血量、术后排气恢复时间、术后住院天数、术后疼痛率、切口感染率均明显低于开腹手术组（P＜0.01）;术后并发症发生率两组差异无统计学意义（P＞0.05）.结论 腹腔镜联合纤维胆道镜治疗胆总管结石具有安全有效、创伤小、术后恢复快等优点,但应根据病人的具体情况确定行一期缝合或T管引流.

Clinical analysis of the treatment 56 cases of choledocholithiasis by laparoscopy combined with choledochoscopy

Objective To evaluate the therapeutic effect of choledocholithiasis treated by laparoscopy combined with choledo- choscopy. Methods The operative time, blood loss, time to passage o f flatus, hospital stay and rates of postoperative pain and com- plications were corn pared between the laparoscopic surgery group （n = 56） and open surgery group （ n = 56）. Results In laparoscop- ic surgery group, the operative time was longer than that in open surgery group （P 〈 0. 01 ）, where as the blood loss, time to passage of flatus, hospitalstay, rates of postoperative pain and wound infection were obviously lower than those in open surgery group （ P 〈 0. 01）. There was no significant difference of postoperative complications between the two groups （P 〉 0. 05）. Conclusions The combined application of laparoscopy and choledochoscopy in the Treatment of choledocholithiasis is safe and effective, and with the ad- vantage of less trauma and quick recovery, but should according to the patient＇s specific circumstances to determine a suture or T tube drainage.