腹腔镜胆总管探查和开腹胆总管探查术后胆道压力变化的对比研究

目的对比分析腹腔镜胆总管探查和开腹胆总管探查术后胆道压力的变化,为胆总管探查可行性提供参考依据。方法 68例胆结石患者随机分成腹腔镜胆总管探查术组和开腹胆总管探查术组,均于术中、术后24、48、72、96小时分别测量两组患者取石后胆道压力的变化情况,并进行统计学分析。结果①两组患者手术后24小时总胆管压力变化较手术中升高,与术中比较有统计学意义(P<0.05或<0.01);②术后48、72小时,OCBDE组胆总管压力变化与术中比较仍有统计学意义(P<0.05),而LCBDE组无统计学意义(P>0.05);③组间比较,OCBDE组术后24、48、72小时胆总管压力变化与LCBDE组比较也有统计学意义(P<0.05或<0.01)。结论腹腔镜胆总管探查较开腹总管探查胆道压力变化小,更适合于患者。

Comparison of pressure changes of the laparoscopic common bile duct exploration and open common bile duct exploration in patients with Choledocholith

Objective To compare the pressure changes of the laparoscopic cormnon bile duct exploration （LCBDE） and open common bile duct exploration（OCBDE） in patients with Choledocholith. Methods 68 patients with Choledocholith were randomly divided into two groups ILCBDE and OCBDE. Their biliary tract pressure changes were detected and analyzed during surgery and the 24,48,72and 96 hours after surgery. Results ①The level of the pressure changes at the 24 hours after surgery was significantly higher than that during surgery in both groups（ P〈0.05 or P〈0.01）. ②The level of the pressure changes of OCBDE group was significantly higher than that of LCBDE group at the 48 and 72 hours after surgery（ P〈0. 05）. ③The level of the pressure changes of OCBDE group was significantly higher than that of LCBDE group at the 24,48,72 hours after surgery（ P〈0. 05）. Conclusion The pressure changes of the laparoscopic common bile duct exploration is less than open common bile duct exploration. Laparoscopic common bile duct exploration is suitable for patients.