腹腔镜联合胆道镜与传统开腹手术治疗胆囊结石合并胆总管结石的疗效对比

目的：：对比分析腹腔镜联合胆道镜与传统开腹手术治疗胆囊结石合并胆总管结石的临床效果。方法：将95例胆囊结石合并胆总管结石患者按术式不同随机分为观察组(50例)和对照组(45例),观察组行腹腔镜联合胆道镜胆囊切除及胆总管切开取石术,对照组行开腹胆囊切除及胆总管切开取石术。观察比较两组患者手术情况、术后并发症发生情况及结石复发情况。结果：观察组术中出血量(50.7±8.3)mL、术后肛门排气时间(2.5±0.8)d及住院时间(6.9±1.2)d均明显少于对照组的(84.6±9.8) mL、(4.1±0.9)d、(13.9±2.4)d,两组比较差异有统计学意义(P<0.05),而观察组手术时间(138.4±10.1) min与对照组(142.5±11.4)min比较差异无统计学意义(P>0.05)；观察组术后并发症发生率为6.0％低于对照组的20.0％,两组比较差异有统计学意义( P<0.05)；观察组结石复发率2.0％低于对照组的4.4％,但无显著差( P>0.05)。结论：腹腔镜联合胆道镜胆囊切除及胆总管切开取石术是治疗胆囊结石合并胆总管结石的有效手术方式,与传统开腹手术相比,术中出血量少、术后恢复快、术后并发症发生率低,是符合该手术条件患者的最佳选择,值得临床推广。

Comparison on Laparoscopy Combined with Choledochoscope and Traditional Open Surgery in the Treatment of Cholecystolithiasis with Choledocholithiasis

Objective: To comparatively analyse on the clinical effect of laparoscopic combined with choledochoscope and traditional open surgery in the treatment of cholecystolithiasis with choledocholithiasis. Methods:95 cases of cholecystolithiasis with choledocholithiasis were randomly divided into observation group (50 cases) and control group (45 cases), observation group underwent laparoscopy combined with choledo-choscope, the control group underwent traditional open surgery. Observed and compared two groups of patients with surgery, postoperative complications and recurrence of stones. Results: There was no significant differ-ence in the operation time between the two groups ( P>0.05);The amount of bleeding in the observation group was significantly reduced compared with the control group, the postoperative anal exhaust time and hospital stay were significantly shorter than the control group, the difference was significant ( P<0.05);The postopera-tive complication rate ( 6%) of the observation group was significantly lower than that of the control group (20%), the difference was significant (P<0.05); The stone recurrence rate in the observation group(2%) was lower than that in the control group (4.4%), but no significant difference (P>0.05). Conclusion: The clinical effect of laparoscopy combined with choledochoscope in the treatment of cholecystolithiasis with chole-docholithiasis is remarkable. Compared with the traditional open operation, the amount of bleeding is less, the recovery is faster and the postoperative complication rate is low, it is worthy of clinical promotion.