腹腔镜联合胆道钬激光治疗胆总管结石的效果分析

目的 探讨腹腔镜联合胆道钬激光治疗胆总管结石的疗效和安全性.方法 选取2017年1月-2018年6月在大连大学附属中山医院进行治疗的76例胆总管结石患者,依据手术方式的不同分为观察组和对照组各38例.观察组在常规腹腔镜基础上联合应用胆道镜钬激光碎石,对照组行腹腔镜常规胆总管探查术.观察并比较两组手术时间、取石时间、术中出血量、T管放置情况、术后胃肠功能恢复时间、住院时间及并发症发生情况等.结果 两组患者均顺利完成手术,无中转开放手术,两组术中出血、术后胃肠功能恢复时间及术后引流时间差异均无统计学意义(P>0.05).观察组手术时间、取石时间和住院时间,均优于对照组,差异均有统计学意义(P<0.05).观察组T管放置率和并发症发生率低于对照组,差异均有统计学意义(P<0.05).结论 腹腔镜联合钬激光碎石术治疗胆总管结石安全有效,且具有手术时间和取石时间短、T管放置率低等优势,值得推广使用.

Clinical Effect of Laparoscopy Combined with Holmium Laser in the Therapy for Choledocholithiasis

Objective To investigate the clinical effect of laparoscopy combined with holmium laser in the therapy for choledocholithiasis.Methods A retrospective analysis was performed in 76 cases of choledocholithiasis hospitalized in gen era I surgery from January 2017 to June 2018.According to the surgical methods,76 cases were divided into observation group and control group,38 cases in each group.Laparoscopic choledochoscopic holmium laser lithotripsy was carried out for the observation group,while the control group was treated with laparoscopic exploration.The general data were compared and analyzed,including operation time,intraoperative blood loss,T tube placement,recovery time of gastrointestinal function after operation,hospital stay and complications.Results The operation was successful without conversion to open surgery in both groups,There were no significant differences in blood loss,recovery time of gastrointestinal function and drainage time between the two groups(P>0.05).The operation and stone removal time,T tube placement rate and hospitalization time in the observation group were significantly shorter than those in the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion In the treatment of choledocholithiasis,laparoscopy combined with holmium laser lithotripsy has shorter operation time and lithotripsy time,lower T-tube placement rate,faster recovery,and better clinical efficacy,which is suitable for popularization and application.