腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石疗效分析

目的:探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石临床疗效。方法:回顾性分析2005年7月～2009年7月153例胆囊结石合并胆总管结石患者行腹腔镜胆总管切开胆道镜取石术的患者与同期122例常规开腹手术患者的临床资料。结果:除残余结石在两组患者间比较差异无统计学意义外(P>0.05),腹腔镜组胆囊结石合并胆总管结石患者手术时间(分钟)、术中失血量(毫升)、肛门排气时间(小时)、切口感染率(%)、住院时间(天)少于或者短于开腹组患者(P<0.05)。对患者进行为期2年的随访,腹腔镜组患者结石复发率明显低于开腹组(P<0.01)。结论:腹腔镜联合胆道镜是一种治疗胆囊结石合并胆总管结石安全可行的方法,具有手术时间短、手术出血量少、恢复快及结石复发少等特点,值得在普外科临床工作中推广应用。

Effect of laparoscope combined with choledochoscope on cholecystolithiasis complicated with choledocholith

Objective: To explore effect of laparoscope combined with choledochoscope on cholecystolithiasis complicated with choledocholith.Methods: Clinical data of 153 cases with cholecystolithiasis complicated with choledocholith,who underwent laparoscope combined with choledochoscope,and 122 cases who underwent conventional open surgery were retrospective analyzed.Results: There was no significant difference in number of residual stones(P>0.05).The surgery time(min),bleeding volume during surgery(mL),anus exhaust time(h),incision infection rate(%),length of hospital stay(d) were significantly less than or short in patients underwent laparoscope combined with choledochoscope(P<0.05).Follow-up for two years showed the recurrence rate of laparoscope group was significantly lower than the open group(P<0.01).Conclusions: Laparoscope combined with choledochoscope is safe and effective.It is of shorter surgery time,less blood loss,rapid recovery,and less recurrence rate,and is worthy of general surgery clinical application.