腹腔镜联合胆道镜行微创保胆取石术治疗胆囊结石的临床应用

目的：探究腹腔镜联合胆道镜行微创保胆取石术对胆囊结石的治疗效果。方法：选取2009年12月至2011年12月我院收治的胆囊结石患者120例，将其随机分为观察组和对照组，每组60例。其中对照组患者采取纤维胆道镜取石术，观察组采取腹腔镜联合胆道镜行微创保胆取石术。术后对患者跟踪随访1年，观察并比较两组患者的结石清除情况、术后并发症、生活质量评分和胆囊壁厚度及胆囊收缩情况。结果：观察组术中出血量明显少于对照组，术后3个月、1年后患者的FACT—G评分较术前明显提高，且观察组术后1年的FAcT—G评分较对照组高；术后1年两组患者的胆囊壁厚度较术前均明显变薄、胆囊收缩功能均明显加强，且观察组患者的胆囊壁厚度较对照组薄，收缩功能较对照组强；观察组术后结石清除率为98．33％，较对照组的76．67％高，并发症发生率、1年后结石复发率分别为1．67％、3．33％，明显低于对照组，P〈0．05，具有统计学意义。结论：腹腔镜联合胆道镜行微创保胆取石术治疗胆囊结石的疗效较好，不仅保留了胆囊的完整性，且术后引起的并发症较少。

Laparoscope Associating Choledochoscope Micro-invasively Taking Stone in Protecting Gallblader for Cholecystolithiasis

Objective： To explore the laparoscopy combined bladder lithotripsy in treatment of patients in our hospital, were randomly divided into observation choledochoscope minimally invasive gall- 2009 to Dec. 2011, 120 cases of gallstone group and the control group, 60 cases in each group. The control group patients took choledochofiberscope to lithotomy, the observation group took laparoscopic of stock choledochoscope line of minimally invasive gallbladder lithotomy. Postoperative patients followed up for 1 year, observed and compared between the two groups of patients with stones to clear the sit- uation, postoperative complications, quality of life scores and gallbladder wall thickness and cholecystokinin situation. Result： The blood loss was significantly less in observation group than that of the control group, after 3 months, 1 year improved significantly in patients with FACT-G score compared with the preoperative and observation group after years of FACT-G 1 year after the two groups of patients were score than the control group high; gallbladder wall thickness of significantly thinner than the preoperative gallbladder function were significantly strengthened and gallbladder wall thickness of the observation group were thin compared with the control group, systolic function than the control group; Observer Group postoperative stone clearance rate was 98.33%, high of 76.67% compared with the control group, the incidence of complications and stone recurrence rate after 1 year were 1.67%, 3.33%, significantly lower than the control group （ p 〈0. 05）, with a statistically significant. Conclusion： The laparoscopy combined choledochoscope minimally invasive gallbladder lithotripsy treatment of gallstone efficacy is better, not only to retain the integrity of the gallbladder, and postoperative complications caused less.