腹腔镜胆囊切除联合胆总管切开胆道镜取石T管引流术治疗胆囊结石并胆总管结石的临床效果

目的 分析腹腔镜胆囊切除联合胆总管切开胆道镜取石T管引流术治疗胆囊结石并胆总管结石的临床效果。方法选取2016年2月至2020年6月我院接收的120例胆囊结石并胆总管结石的患者作为研究对象,根据手术方式的不同分将其为对照组（60例,开腹胆囊切除+胆总管切开胆道镜取石T管引流术）和观察组（60例,腹腔镜胆囊切除+胆总管切开胆道镜取石T管引流术）。比较两组的手术相关指标、术后并发症发生情况、血清相关指标（TBIL、ALT、ALP、GGT、Na+）及生活质量评分。结果 观察组的手术时间长于对照组,术中出血量少于对照组,腹腔引流时间、肠道功能恢复时间以及住院时间短于对照组,差异具有统计学意义（P<0.05）。观察组的术后并发症总发生率为6.67%,显著低于对照组的21.67%,差异具有统计学意义（P<0.05）。术后,两组的血清TBIL、ALT、ALP、GGT及Na+水平均较术前显著降低,且观察组低于对照组（P<0.05）。术后,两组的GIQLI评分均较术前显著升高,且观察组高于对照组,差异具有统计学意义（P<0.05）。结论 腹腔镜胆囊切除联合胆总管切开胆道镜取石T管...

Clinical effect of laparoscopic cholecystectomy combined with choledochotomy choledochoscopic lithotomy and T-tube drainage in the treatment of cholecystolithiasis complicated with choledocholithiasis

Objective To analyze the clinical effect of laparoscopic cholecystectomy combined with choledochotomy choledochoscopic lithotomy and T-tube drainage in the treatment of cholecystolithiasis complicated with choledocholithiasis.Methods A total of 120 patients with cholecystolithiasis complicated with choledocholithiasis received in our hospital from February 2016 to June 2020 were selected as the research objects.According to different operation methods,the patients were divided into control group(60 cases,open cholecystectomy + choledochotomy choledochoscopic lithotomy and T-tube drainage) and observation group(60 cases,laparoscopic cholecystectomy + choledochotomy choledochoscopic lithotomy and T-tube drainage).The operation related indexes,postoperative complications,serum related indexes(TBIL,ALT,ALP,GGT,Na+) and quality of life scores were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,and the amount of intraoperative blood loss was less than that of the control group,the abdominal drainage time,the recovery time of intestinal function and the length of hospital stay were shorter than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the observation group was 6.67%,which was significantly lower than 21.67% in the control group,and the difference was statistically significant( P <0.05).After operation,the levels of serum TBIL,ALT,ALP,GGT and Na+in the two groups were significantly lower than those before operation,and those in the observation group were lower than the control group( P <0.05).After operation,the GIQLI score of the two groups was significantly higher than that before operation,and that of the observation group was higher than the control group,and the difference was statistically significant(P <0.05).Conclusion Laparoscopic cholecystectomy combined with choledochotomy choledochoscopic lithotomy and T-tube drainage in the treatment of cholecystolithiasis complicated with choledocholithiasis can effectively improve the operation related indexes,reduce the incidence of postoperative complications and the levels of serum related indexes,and improve the prognosis and quality of life of patients.