LCBDE与OCBDE治疗胆总管结石的临床疗效对比

目的：探讨腹腔镜胆总管探查术（LCBDE）与开腹胆总管探查术（OCBDE）治疗胆总管结石的临床疗效对比。方法：将75例胆总管结石患者分为LC组（n=35）和OC组（n=40）。LC组采用腹腔镜胆总管探查术治疗。OC组采用开腹胆总管探查术治疗。对比两组手术治疗效果及肝功能变化情况。随访6个月，对比两组并发症及结石残余情况。结果：两组一次性结石清除率、手术时间对比差异无统计学意义；LC组手术失血量、首次通气时间、住院时间均显著低于OC组，差异有显著性意义；手术后，两组总胆红素（TBIL）、谷丙转氨酶（ALT）、谷草转氨酶（AST）均显著降低；两组术后TBIL、ALT、AST差异无统计学意义；LC组并发症发生率（8.57%）显著低于OC组（32.50%），差异有统计学意义。结论：LCBDE治疗胆总管结石的疗效确切，具有创伤小、恢复快、并发症少等优势。

Comparison of clinical therapeutic effect of LCBDE and OCBDE in the treatment of common bile duct stones

Objective To explore the clinical effect of laparoscopic common bile duct exploration(LCBDE)and open com-mon bile duct exploration(OCBDE)in the treatment of common bile duct stones. Methods 75 cases of patients with common bile duct stones were divided into LC group(n=35)and OC group(n=40). Laparoscopic common bile duct exploration was used in the LC group. OC group was treated with open common bile duct exploration. The effect of operation and the changes of liver func-tion were compared between the two groups. After 6 months follow-up, the complications and residual stones in two groups were compared. Results There was no significant difference in the rate of stone removal and operation time between the two groups . The amount of blood loss, ventilation time and hospitalization time were significantly lower in group LC than in group OC. The difference was significant . After surgery, the two groups TBIL, ALT, AST were significantly reduced . There was no significant difference in TBIL, ALT and AST between the two groups . The incidence of complications(8.57%)in group LC was significantly lower than that in group OC(32.50%). The difference was statistically significant. Conclusion LCBDE is effective in the treat-ment of common bile duct stones, with the advantages of less trauma, faster recovery, less complications and so on.