腹腔镜不同方式治疗胆囊结石合并胆总管结石的临床分析

目的 对腹腔镜不同方式治疗胆囊结石合并胆总管结石的疗效进行比较和评价.方法 回顾性分析2000年6月至2004年10月,24例行腹腔镜胆囊切除、胆总管探查、一期缝合术(A组),21例行腹腔镜胆囊切除、胆总管探查、T管引流术(B组),22例行腹腔镜胆囊切除联合内镜乳头括约肌切开取石术(C组)患者的手术及术后情况.结果 A组手术时间少于B组(P＜0.05),A组住院时间、术后用药时间均少于B组和C组(P＜0.01,P＜0.05).三组患者术中出血量及并发症的发生率比较差异无统计学意义(P＞0.05).结论 腹腔镜胆囊切除、胆总管探查、一期缝合术是治疗胆囊结石并胆总管结石疗效肯定的微创手术,其保持了Oddi括约肌的完整性,缩短了住院时间和术后用药时间,降低了患者的费用.

Clinical analysis of different laparoscopic treatments for cholecystolithiasis and choledocholithiasis

Objective To evaluate the therapeutic effect of different laparoscopic treatments for cholecystolithiasis and choledocholithiasis.Methods From June 2000 to October 2004,24 cases receiving primary duct closure (group A) and 21 cases receiving T-tube drainage (group B) after laparoscopic cholecystectomy and choledochotomy,and 22 cases receiving endoscopic sphincterotomy and laparoscopic cholecystectomy (group C) were analyzed retrospectively.Results Compared with group B,the average operating time in group A was shorter (P<0.05).The average hospital stay and medication time were shorter in group A than those in group B and group C (P<0.01,P<0.05).There was no significant difference in blood loss and complication morbidity during operation among the 3 groups.Conclusion The primary duct closure after laparoscopic cholecystectomy and choledochotomy for treating cholecystolithiasis and choledocholithiasis is a safe and feasible technique with affirmative curative effect and mild invasion.This operation preserves the function of Oddi sphincter and shortens the hospital stay,medication time and it relieves the cost of patients.