腹腔镜联合胆道镜治疗胆总管结石临床疗效分析

目的探讨腹腔镜联合纤维胆道镜治疗胆总管结石的可行性及临床疗效分析。方法选取2009年1月~2013年12月在我院行手术治疗胆总管结石患者144例。按手术方式的不同分组,行腹腔镜联合胆道镜治疗80例为观察组,开腹手术治疗64例为对照组。观察并比较两组：（1）手术情况：包括手术时间、术中失血量、术后排气时间、术后并发症情况、住院时间等。（2）治疗效果：包括术后胆总管通畅率、结石残余率、复发率,手术治愈率等。结果 144手术均获成功。其中观察组在术中出血量、术后胃肠功能恢复时间、术后并发症发生率、住院天数等方面均优于对照组（P〈0.05）。结论腹腔镜和胆道镜双镜联合治疗胆总管结石安全有效、损伤小、恢复快,术中出血少、疼痛反应轻、住院时间短及术后并发症少等优点。是目前治疗胆道结石较理想的微创术式。但术者需要掌握熟练的操作技能。

Clinical analysis of laparoscopy combined with choledochoscopy in treatment of bile duct stones

Objective To observe the feasibility and clinical effect of laparoscopy combined with choledo- choscope in the treatment of bile duct stones. Methods Retrospective analysis of the clinical date of 144 cases underwent operation treatment of common bile duct stonesfrom January 2009 to December 2013 in hospital. The 144 cases were selected and randomy divided into experimental group and control group. 80 cases in experimental group were treated with laparoscope combined with choledochoscope, 64 cases in con- trol group were received laparotomy, we observed and compared by the two group. （ 1 ） operation time, intra- operative blood loss,intestinal function recovery time, postoperative complications, hospitalization days; （2）postoperative bile ductUnobstructed rate, residual stone rate, recurrence rate, the cure rate of operation. Results the operation was successful in all 144. The experimental group in the intraoperative blood loss, postoperative intestinal function recovery time,postoperative complication rate,hospitalization days were better than the control group （P〈0.05）. Conclusions the advantages of aparoscopy combined with choledo- choscopy in treatment of bile duct stones include safe and effective,minimal injury,quick recovery,less bleeding less pain, shorter hospitalization time and fewer postoperative complications. It is an ideal minimally invasive surgical treatment of bile duct stones at present. But the surgeon requires skilled operationtechnique.