微创保胆取石术与腹腔镜胆囊切除术的临床疗效比较

目的：探讨微创保胆取石术与腹腔镜胆囊切除术治疗胆囊结石的临床疗效,为治疗策略的制定提供参考。方法：选取60例胆囊结石患者作为研究对象,随机分为观察组与对照组,每组30例。观察组行微创保胆取石术,对照组行腹腔镜胆囊切除术。对比两组患者手术时间、术中出血量、术后首次肛门排气时间、术后镇痛治疗、术后住院时间、切口感染及术后随访情况。结果：观察组术中出血量平均（14.63±5.18）ml,手术时间平均（39.26±5.12）min,均显著低于对照组（P〈0.05）;两组患者术后肛门首次排气时间、术后住院时间、术后镇痛药物使用例数、切口感染率均相当（P〉0.05）。术后随访,观察组术后腹胀腹泻、消化不良发生率为3.33%,显著低于对照组（13.33%）（P〈0.05）;胆总管结石发生率两组患者差异无统计学意义（P〉0.05）,两组均无复发。结论：对于符合保胆手术指征的患者,微创保胆取石术具有手术时间短、术中出血少、临床疗效好等优点。

Comparison of the clinical effect of minimally invasive gallbladder-preserved cholecystolithotomy and laparoscopic cholecys- tectomy

Objective ： To investigate the clinical effec.t of minimally invasive gallbladder-preserved cholecystolithotomy and lap- aroscopic cholecystectomy in patients with gallstone, and to provide a reference for the treatment strategies. Methods：Sixty patients with gallstone were selected and randomly divided into observation group and control group with 30 cases in each. The patients in the obser- vation group were treated by mini-cholecystolithotomy,while in the control group laparoscopic eholeeystectomy treatment was used. The operation time, intraoperative bleeding volume, postoperative anal exhaust time, postoperative analgesia, postoperative hospital stay, woumt infection and postoperative follow-up were compared between both groups. Results：In the observation group, the bleeding volume was （14.63 ＋5.18） ml and the operation time was （39.26 -＋5.12） rain,which were significantly less than those in the control group （P 〈 0.05 ）. No significant difference was found between the two groups in postoperative anal exhaust time,postoperative hospital stay, postoperative analgesic drug, postoperative infection and follow-up time. The abdominal distension, diarrhea and indigestion incidence was 3.33% in the observation group,which was significantly lower than that in the control group （ 13.33% ）. No significant differenee was fimnd in postoperative choledocholithiasis recurrence rate between the two groups. And no recurrence of choleeystolithiasis was ob- served. Conclusions：As to the patients who has gallbladder-preserving operation indication, minimally invasive gallbladder-preserved choleeystolithotomy achieves shorter operation time,less blood loss and better clinical efficaey.