腹腔镜联合胆道镜治疗老年患者肝外胆管结石的疗效分析

目的探讨腹腔镜联合胆道镜治疗老年患者肝外胆管结石的临床效果。方法回顾性分析2012年1月至2016年5月我科收治的老年肝外胆管结石患者82例,分为观察组(43)例和对照组(39例)。观察组采用腹腔镜联合胆道镜进行治疗,对照组采用传统的开腹手术治疗,观察两组治疗效果及安全性。结果观察组患者出血量、手术时间、排气时间、住院时间均明显小于对照组(P0.05)。观察组结石残留率、切口感染的发生率也明显低于对照组(P0.05),但是胆道出血、胆道感染、胆漏的发生率两组无明显统计学差异。结论临床上采用腹腔镜联合胆道镜治疗老年患者肝外胆管结石效果确切,并发症发生几率小,有较好的应用前景。

Clinical analysis of laparoscopy combined with choledochoscopy in treatment of elderly patients with extrahepatic bile duct stones

Objective To investigate the clinical effect of laparoscopy combined with choledoehoscopy in the treatment of elderly patients with extrahepatic bile duct stones.Methods A total of 82 elderly patients with extrahepatic bile duct stones in our hospital from January 2014 to May 2016 was retrospectively analyzed.The patients were divided into observation group (n =43) and control group (n =39).The observation group was treated with laparoscopy combined with choledochoscopy,while the control group was treated with traditional operation.The therapeutic effect and safety of the two groups were observed.Results The amount of bleeding,operation time,exhaust time,hospitalization time in the observation group were significantly lower than those in the control group (P ＜0.05).The rate of residual stones and wound infection in the observation group were significantly lower than those in the control group (P ＜ 0.05),but there was no significant difference between the two groups in the incidence of biliary tract bleeding,biliary infection and bile leakage.Conclusion Laparoscopy combined with choledochoscopy in the treatment of elderly patients with extrahepatic bile duct stones is effective,and the incidence of complications is low,and this method has a good prospect in clinical application.