腹腔镜手术与开腹手术行胆总管切开取石的对比研究

目的对比腹腔镜手术与开腹手术治疗胆总管结石的临床效果。方法将169例胆囊结石合并胆总管结石患者随机分为腹腔镜手术组（85例腹腔镜胆道探查取石，即LCH-TD）与开腹手术组（84例常规胆总管探查，即OCH-TD），分析对比两组患者的临床资料。结果腹腔镜手术组术中出血量、术后肠呜音恢复时间、住院时间、术后疼痛、胆漏情况均显著优于开腹手术组（均P〈0．05），两组手术后T管造影均未发现残余结石。结论LCH-TD术式微创，临床效果好，能取代大部分开腹胆总管探查术。

A comparative study of choledocholithotomy by open and laparoscopic surgery

Abstract:Objective:To compare the clinical results of choledocholithotomy by laparoscopic surgery and open surgery.
Methods: One hundred and Sixty-nine patients with cholecystoithiasis combined with choledocholithiasis were divided into laparoscopic surgery group(85 cases of laparoscopic choledocholithotomy, LCD-TD) and open surgery group (84 cases of open choledocholithotomy, OCH-TD). The clinical data in the two groups were compared and analyzed.
Results:The amount of intraoperative bleeding, the recover time of intestinal peristalsis after treatment, length of hospital stay, cases of postoperative pain and biliary fistulas in laparoscopic surgery group were evidently better than those of open surgery group(all P<0.05). No residual calculi were found on T-tube radiogram in both groups.
Conclusions:LCH-TD surgery is minimally traumatic, has good clinical results, and in most cases, can replace open choledocholithotomy.