腹腔镜下胆道镜联合螺旋水刀碎石治疗肝内胆管结石的临床应用

目的：探讨腹腔镜下胆道镜联合螺旋水刀碎石治疗肝内胆管结石的临床疗效和应用价值。 方法：比较51例腹腔镜下胆道镜联合螺旋水刀治疗肝内胆管结石和56例开腹手术下胆道镜联合螺旋水刀治疗肝内胆管结石的临床资料，观测指标有结石清除率、手术时间、术后镇痛、肛门排气时间、术后并发症等。 结果：两组患者在结石清除率、性别、年龄、结石大小等比较差异无统计学意义。开腹组和腹腔镜组患者在手术时间（min）（150.3±36.5 vs 176.4±41.1，P = 0.003）、术后镇痛（41例 vs 14例，P = 0.005）、肛门排气时间（h）（57.2±13.7 vs 29.1±8.1，P = 0.000）、术后并发症（18例 vs 5例，P = 0.009）等方面比较，差异有统计学意义。 结论：腹腔镜下胆道镜联合螺旋水刀碎石治疗肝内胆管结石是安全、微创、有效的方法。

Clinical application of laparoscopy with choledochoscope and helix hydro-jet in the treatment of intrahepatic lithiasis

Objective：To investigate the effect and application in the treatment of intrahepatic lithiasis by laparoscopy with choledochoscope and helix hydro-jet. Methods：A prospective comparison was conducted between 51 patients treated by laparoscopy with choledochoscope and helix hydro-jet and 56 by open operation with choledochoscope and helix hydro-jet. Such terms as stone removal, operation time, postoperative analgesia, postoperative anus exhaust time, and postoperative complications were taken into consideration. Results：The two groups of patients have no statistically significant differences on stone clearance rate , gender , age, and stone size, whereas operation time, postoperative analgesia, anal exhaust time, and postoperative complications show significant differences （P 〈 0.01）. Conclusion：It is safe, effective and minimally invasive to treat intrahepatic lithiasis by laparoscopy with choledochoscope and helix hydro-jet.