3D腹腔镜联合硬镜在微创保胆取石术中的应用研究

目的探讨3D腹腔镜联合硬镜行微创保胆取石术治疗胆囊结石的临床效果。方法选择66例胆囊结石患者,随机分为观察组和对照组,各33例。观察组患者行3D腹腔镜联合硬镜微创保胆取石术治疗,对照组患者行2D腹腔镜联合硬镜微创保胆取石术治疗。比较两组患者的治疗效果。结果所有手术均顺利完成,无中转开腹或转变手术方式行胆囊切除术。两组结石取净率均为100%。观察组手术时间、胆囊切口缝合时间少于对照组(均P<0.05)。两组术中出血量、结石取净率、术后住院时间、并发症发生率比较差异无统计学意义(均P>0.05)。术后随访12个月,两组胆囊结石复发均为1例(3.03%)。结论与2D腹腔镜相比,3D腹腔镜联合硬镜在微创保胆取石术中可减少胆囊切口缝合时间、手术时间,手术安全、可行、高效,具有较好的临床应用前景。

Application of 3D laparoscopy combined with rigid choledochoscopy in minimally invasive gallbladder-preserved cholecystolithotomy

Objective To explore the clinical effect of 3 D laparoscopy combined with rigid choledochoscopy applied to minimally invasive gallbladder-preserved cholecystolithotomy in cholecystolithiasis treatment.Methods Sixty-six patients with cholecystolithiasis were enrolled and randomly divided into observation group and control group,with 33 cases in each group.Patients in the observation group were treated with minimally invasive gallbladder-preserved cholecystolithotomy using 3 D laparoscopy combined with rigid choledochoscopy,while patients in the control group received minimally invasive gallbladder-preserved cholecystolithotomy using 2 D laparoscopy combined with rigid choledochoscopy.The therapeutic effects were compared between the two groups.Results All patients completed the operation successfully,and no conversion to open surgery or change of operation approach for cholecystectomy occurred.The calculi removal rate was 100%in both groups.The operation duration and gallbladder incision suture time in the observation group were less than those in the control group(all P<0.05).There were no statistically significant differences in intraoperative blood loss,calculi removal rate,postoperative hospital stay,or the incidence rate of complication between the two groups(all P>0.05).After 12 months of follow-up,one case suffering from recurrent cholecystolithiasis was observed in each group(3.03%).Conclusion Compared with 2 D laparoscopy,3 D laparoscopy combined with rigid choledochoscopy can shorten the suture time and operation duration of gallbladder incision in minimally invasive gallbladder-preserved choledostolithotomy,which is safe,feasible and efficient,with a preferable clinical application prospect.