腹腔镜、胆道镜联合治疗胆总管结石的临床研究

目的：探讨腹腔镜胆道镜胆总管探查取石的可行性、安全性及适应证。方法：对比分析腹腔镜手术组（n=20）与开腹手术组（n=20例）胆总管探查取石术的手术时间、术中出血量、术后排气时间、住院天数、术后疼痛、并发症发生率等。结果：腹腔手术组与开腹手术组手术时间分别为（133.65±16.71）min、（89.8±11.02）min,术后止痛剂使用率分别为20%、85%,术后排气时间分别为（31.15±4.98）h、（56.65±13.45）h,住院时间分别为（8.55±2.11）d、（14.95±2.96）d。以上项目两组均有统计学差异（P〈0.01）;并发症发生率分别为10%、25%,无明显差异（P〉0.05）。结论：腹腔镜联合胆道镜胆总管切开取石术安全可靠,手术创伤小,值得临床推广。

Clinical research on the combined application of laparoscopy and choledochoscopy in treatment of choledocholith

Objective:To evaluate the feasibility,safety,and indication of the combined application of laparoscopy and choledochoscopy in common bile duct exploration.Methods:The operative time,blood loss,venting time,hospitalization,postoperative pain and complications were compared between the laparoscopic procedure group(n=20)and open procedure group(n=20).Results:The operative time,analgesic usage rate,venting time and hospitalization of the two groups were(133.65±16.71)min vs.(89.8±12.02)min,20% vs.85%,(31.15±4.98)h vs.(56.65±13.45)h,and(8.55±2.11)d vs.(14.95±2.96)d respectively,all of which had significant difference(P<0.01).Complication rate was 10% and 25% respectively,which had no significant difference(P>0.05).Conclusions:The combined application of laparoscopy and choledochoscopy in choledocholith is safe and effective with the advantage of less trauma,thus worth being widely used clinically.