腹腔镜胆道探查术治疗胆囊结石合并胆总管结石的临床观察

目的探讨腹腔镜胆道探查术治疗胆囊结石合并胆总管结石的临床疗效。方法将128例胆囊结石合并胆总管结石患者随机分为观察组和对照组各64例,两组患者均行全身麻醉,观察组患者接受腹腔镜胆道探查术治疗胆囊结石合并胆总管结石,对照组患者接受传统手术治疗胆囊结石合并胆总管结石,两组患者术后常规抗感染治疗。比较两组患者的手术情况、术后恢复情况、住院时间及费用、术后并发症情况以及术后残石率等情况。结果与对照组比较,观察组患者切口显著缩小(P<0.01),手术时间、下床时间、术后通气时间、肠鸣音恢复时间、导尿管留置时间、术后住院时间及住院总时间显著缩短(均P<0.01),术中失血量显著减少(P<0.01),而住院总费用增加(P<0.01)。观察组切口感染显著低于对照组(P<0.05),但是两组术后并发症整体比较差异无统计学意义(P>0.05)。两组患者术后残留结石差异无统计学意义(P>0.05)。结论腹腔镜胆道探查术治疗胆囊结石合并胆总管结石创伤小,恢复快,安全可靠,疗效确切,值得临床推广应用。

Clinical observation of laparoscopic common bile duct exploration to treat cholecystolithiasis combined with choledocholithiasis

Objective To explore the clinical effect of laparoscopic common bile duct exploration to treat cholecys- tolithiasis combined with eholedoeholithiasis. Methods A total of 128 patients with eholeeystolithiasis combined with eholedoeholithiasis, who visited the General Surgery department of our hospital in January 2010- December 2011, were divided randomly into Observation Group and Control Group. Cases in Observation Group received laparoscopie common bile duct exploration, and cases in Control Group received traditional operation. Cases in both groups received traditional anti-infection treatment after operation. The operation conditions, recovery of operation, hospital stays and expense, as well as complication after operation and residual bile duct stones were compared in both groups. Results he cut size was significantly reduced in Observation Group compared to Control Group （P〈0. 01）, and offbed time, exhaust time, time of resuming peristaltic sound, retention time of catheter after operation, hospital stays after operation and whole hospital stays in Observation Group was significantly shortened compared to Control Group（P〈0. 01）. Blood loss during the op- eration in Observation Group was significantly less compared to Control Group （P〈0.01）. The rate of cut infection in Observation were significantly less, but rate of total complication after operation were not significantly different compared to Control Group （P〈0. 05）. Residual bile duct stones in both groups was not significantly different in statistic （P〈 0.05）. Conclusion laparoscopie common bile duct exploration is of less trauma, rapid recovery, safe and definite effect, and worthy to be recommanded.