三镜联合治疗胆囊结石合并胆总管结石的临床优势

【摘要】 目的 探讨三镜联合治疗胆囊结石并胆总管结石的临床优势。方法〓将汕尾市第二人民医院普外科2010年2月至2015年10月期间共处理胆囊结石伴难处理的胆总管下端结石44例患者作为研究对象(改进组),采用三镜(即腹腔镜、十二指肠镜、胆道镜)联合治疗。另选择同期采用常规腹腔镜和胆道镜(双镜)治疗患者44例为对照组。比较两组患者临床治疗效果。结果〓手术中转开腹率、结石残留率、术后并发症发生率两组比较差异无统计学意义(P>0.05);改进组的手术时间、术中失血量、术后住院时间均低于对照组,差异有统计学意义(P<0.05)。结论 三镜联合治疗胆囊结石并胆总管结石,较传统的双镜联合方式具有明显优势。

Clinical advantage of endoscopy-assistant laparoscopic procedure in treatment for concomitant gallstone and common bile duct stone

Objective To explore the advantages of the combination of three kinds of endoscopies in treatment of gallbladder stone combined with common bile duct stones. Methods Eighty-eight cases of patients with gallstone combined with common bile duct stones were selected from the Second People’s Hospital of Shanwei from February 2010 to October 2015..The patients were assigned to two groups, EST+LAP group and control group. The patients in EST+LAP group (n=44) were subjected to laparoscopic procedure for treating concomitant gallstone and common bile duct stone by using combining endoscopic sphincterotomy and choledochoscope..The controls were performed common laparoscopic cholecystectomy and exploration of the common bile duct. .The clinical effects were compared between two groups. Results There were no statistical differences in the rates of transfer to open operation, residual stone and postoperative complications between two groups. The operative time, blood loss, postoperative hospitalization time in EST+LAP group were lower than those in the control group (all P values less than 0.05). Conclusion EST-assistant laparoscopic procedure for treating gallbladder stone combined with common bile duct stones has obvious advantages to traditional surgical method.