腹腔镜联合胆道镜保胆取石术的临床应用

目的探讨腹腔镜联合胆道镜保胆手术（LRCL）的临床价值。方法回顾对比分析腹腔镜联合胆道镜保胆手术观察组30例与同期腹腔镜胆囊切除术（LC）对照组．30例的临床资料，观察两组患者术中出血量、手术时间、术后进食时间、住院时间及术后并发症的情况。结果两组患者均顺利完成手术，但观察组的术中出血量少于对照组（P〈0．01），手术时间、术后进食时间和住院时间短于对照组（P均〈0．01）；观察组无术后胆管损伤并发胆汁漏、肺部感染及切口感染发生；而对照组术后因胆管损伤并发胆汁漏2例（6．67％），元术后肺部感染及切口感染发生。结论在基层医院开展腹腔镜联合胆道镜保胆取石手术患者创伤小、效果好、安全可靠。

Clinical observation of laparoscopy combined with choledochoscopy in preservation of cholecyst and removal of calculus.

Objective To explore clinical value of laparoscopy combined with choledochoscopy in preserva- tion of cholecyst andremoval of calculus. Methods Sixty patients with gallstone were divided into observation group and the control group, the observation group （n = 30 ） received laparoscopy combined with choledochoscopy for preser- vation of cholecyst and removal of calculus, and the control group （n = 30） received traditional laparoscoic cystectomy. The intraoperative bleeding volume, operative time, postoperative time, duration of hospitalization and complications were observed. Results All patients were successfully completed surgery. The intraoperative bleeding volume, oper- ative time, postoperative time, duration of hospitalization in the observation group were less than those in the control group,the difference between the groups was significant（all P 〈 0. 01 ）, No complications was found in the observa- tion group; In the control group, biliary fistuta was found in 2 cases （6. 67% ） , there was no postoperative pulmonary infection and incision infection was found. Conclusion The laparescopy combined with choledochoscopy in preserva- tion of cholecyst and removal of calculus is a safe and effective surgery.