腹腔镜联合胆道镜胆总管切开取石术治疗胆总管结石患者的效果

目的:观察腹腔镜联合胆道镜胆总管切开取石术治疗胆总管结石患者的效果。方法:选取82例胆总管结石患者作为研究对象,按照随机数字表法分为观察组与对照组各41例。对照组行开腹取石术治疗,观察组行腹腔镜联合胆道镜胆总管切开取石术治疗,比较两组围术期指标(手术时间、出血量、术后肛门排气时间及住院时间)水平、肝功能指标谷草转氨酶(AST)、总胆红素(TBIL)、谷丙转氨酶(ALT)]水平、并发症发生率和术后1年复发率。结果:观察组手术时间、术后肛门排气时间和住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后,两组AST、TBIL、ALT水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率和术后1年复发率均明显低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜联合胆道镜胆总管切开取石术治疗胆总管结石患者可缩短手术时间、术后肛门排气时间和住院时间,减少术中出血量,以及降低肝功能指标水平、并发症发生率和1年复发率,其效果优于开腹取石术治疗。

Effects of laparoscopic and choledochoscopic choledocholithotomy in treatment of in patients with common bile duct calculus

Objective:To analyze effects of laparoscopic and choledochoscopic choledocholithotomy in treatment of in patients with common bile duct calculus.Methods:82 patients with common bile duct calculus were selected as the research objects,and were divided into observation group and control group according to the random number table method,41 cases in each group.The control group was treated with laparotomy,while the observation group was treated with laparoscopic and choledochoscopic choledocholithotomy.The perioperative indicator(operation time,blood loss,postoperative anal exhaust time and hospitalization time)levels,liver function indicatoraspartate aminotransferase(AST),total bilirubin(TBIL),and alanine aminotransferase(ALT)]levels,complication rate and 1-year recurrence rate were compared between the two groups.Results:The operation time,postoperative anal exhaust time and hospitalization time in the observation group were shorter than those in the control group;the intraoperative blood loss was less than that in the control group;and the differences were statistically significant(P<0.05).After the surgery,the levels of AST,TBIL,and ALT in the two groups were higher than those before the surgery;those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05).The complication rate and 1-year recurrence rate in the observation group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Laparoscopic and choledochoscopic choledocholithotomy in the treatment of the patients with common bile duct calculus can shorten the operation time,the postoperative anus exhaust time and the hospitalization time,reduce the intraoperative blood loss,and reduce the levels of liver function indicators,the incidence of complications and the 1-year recurrence rate.Moreover,it is superior to laparotomy.