腹腔镜辅助胆道镜下胆总管切开取石的临床研究.pdfVIP

腹腔镜辅助胆道镜下胆总管切开取石的临床研究 陈建荣，顾王争 于进玲，顾建萍，李先玮，张学利 （上海市奉贤区中心医院，上海市交通大学附属第六人民医院奉贤分院，上海 201400 ） [摘要] 目的 探讨腹腔镜辅助胆道镜下胆总管切开取石的可行性 及临床应用价值。 方法 将我院 2009.1-2010.10 间择期手术的 60 例胆囊合并胆总管结石患者随机分为腹腔镜辅助胆道镜下胆总管切 开取石治疗组（以下简称二镜组）和传统开腹胆囊切除+胆总管切开 取石治疗组（以下简称开腹组）采用SPSS11.0 软件对两组手术时间、 术后并发症例数、伤口疼痛、术后肛门排气恢复时间、术后住院时间、 住院总费用的指标进行分析，P 0.05 为差异有统计学意义。 结果 两组病例均无死亡，二镜组未发生中转开腹手术。术后随访6 个月以 上者二镜组21 例、开腹组22 例。两组的手术时间、住院总费用比较 P0.05 ，无明显差异。而术后肛门恢复排气时间、伤口疼痛率、术后 住院时间、术后并发症发生率比较，均 P0.01 ，二镜组明显优于开 腹组。 结论 腹腔镜辅助胆道镜下胆总管切开取石是一种新兴的微 创手术，只要正确掌握适应证，严格禁忌证，手术成功率高，并发症 少，是目前治疗胆囊合并胆总管结石较为理想的微创手术方式。 [关键词] 胆囊结石；胆总管结石；腹腔镜；胆道镜；胆总管探查 [中图分类号] R654.4 [文献标识码] B [文章编号] The Clinical Research on Laparoscopy -assisted Choledochofiberscopic Choledocholithotomy Chen Jianrong, Gu Zheng,,Yu Jinling, et al. Department of General Surgery of Shanghai Fengxian Distrist Hospital,Shanghai,201400 Abstract Objective To discuss the feasibility and clinical value of laparoscopy-assisted choledochofiberscopic choledocholithotomy. Methods 60 patients with cholecystolithiasis and choledocholithiasis,who were hospitalized from Jan 2009 to Oct 2010,were randomly and equally divided into 2 groups.30 patients(Group A) underwent laparoscopy-assisted choledochofiberscopic choledocholithotomy. Other 30 patients (Group B) underwent open cholecystectomy and choledocholithotomy. The patients’ surgery time, post-operative complications, incisional pain, hospital charges, hospital time and gastrointestinal function recovery time of both groups were analyzed with SPSS11.0, and there is statistical significance when P0.05. Results There were no cases of deaths in our study. There is no 作者简介：陈建荣（1974-- ）男，上海人，主治医师。 通讯作者：张学利，教授，博士，硕导，Email:lejing1996@yahoo.cn。 significant difference in surgery time or hospital charges bet