腹腔镜联合胆道镜下胆囊部分切除保胆术治疗胆囊结石合并胆囊畸形的临床效果

目的 探讨腹腔镜联合胆道镜下胆囊部分切除保胆术治疗胆囊结石合并胆囊畸形的临床效果.方法 将胆囊结石合并胆囊畸形患者98例,分为观察组49例与对照组49例,对照组采用开腹胆囊切除取石术,观察组采用腹腔镜联合胆道镜下胆囊部分切除保胆术,比较两组患者手术时间、术中出血量、术后胃肠功能恢复时间、术后住院时间、术后并发症及复发率.结果 两组患者手术时间比较,差异无统计学意义(P>0.05),观察组术中出血量、术后胃肠功能恢复时间及术后住院时间均少于对照组(P<0.05).观察组术后切口感染、胰腺炎、胆汁漏、肺部感染等并发症总发生率低于对照组(P<0.05).两组患者术后6个月胆囊结石复发率比较,差异无统计学意义(P>0.05).结论 腹腔镜联合胆道镜下胆囊部分切除保胆术治疗胆囊结石合并胆囊畸形疗效确切,能减少患者的术中出血及术后恢复时间,降低术后并发症的发生率,且不增加复发率.

Clinical efficacy of partial cholecystectomy and gallbladder preservation under laparoscope and choledochoscope for the treatment of gallbladder stone complicated with gallbladder deformity

Objective To explore the clinical efficacy of partial cholecystectomy and gallbladder preservation under laparoscope and choledochoscope for the treatment of gallbladder stone complicated with gallbladder deformity .Methods A total of 98 patients with gallbladder stone complicated with gallbladder deformity were divided into observation group or control group ,with 49 cases in each group . Open cholecystectomy and lithotomy were conducted in the control group.Partial cholecystectomy and gallbladder preservation under laparoscope and choledochoscope were conducted in the observation group .Operation time,intraoperative blood loss,recovery time of postoperative gastrointestinal function , postoperative hospital stay , postoperative complications and recurrence rate were compared between the two groups.Results There was no significant difference in the operation time between the two groups (P>0.05).The intraoperative bleeding loss,recovery time of postoperative gastrointestinal function ,and postoperative hospital stay in the observation group were obviously less than those in the control group(P<0.05).The total rate of postoperative complications including incision infection,pancreatitis,bile leakage,and pulmonary infection in the observation group was significantly lower than the rate in the control group (P<0.05).There was no significant difference in the recurrence rate of gallbladder stone at 6 months after surgery between the two groups (P>0.05).Conclusion Partial cholecystectomy and gallbladder preservation under laparoscope and choledochoscope can acquire a definite therapeutic efficacy for gallbladder stone complicated with gallbladder deformity ,reduce the intraoperative blood loss ,postoperative recovery time ,and incidence of postoperative complications,and does not increase the recurrence rate .