腹腔镜和胆道镜联合治疗胆总管结石的疗效分析.docVIP

腹腔镜和胆道镜联合治疗胆总管结石的疗效分析 　　[摘要] 目的 探讨腹腔镜联合胆道镜治疗胆总管结石的临床疗效。方法 随机选择2014年1月―2016年3月期间在该院行手术治疗的60例胆总管结石患者，随机分为对照组和观察组各30例。对照组常规行开腹手术取石，观察组行腹腔镜联合胆道镜切开胆管取石术（LCBDE），比较两组患者术中出血/补液、术后恢复、并发症情况。 结果 观察组术中出血量（121.36±14.36）min、术中补液量（2 475.65±520.70）mL、术后排气时间（20.96±5.25）h、下床活动时间（14.56±4.26）h、术后住院时间（6.69±0.68）d均显著少于对照组（P0.05）。观察组并发症率（6.67%）显著低于对照组（23.33%），差异有统计学意义（P0.05）。结论 胆总管结石采用腹腔镜联合胆道镜治疗效果较为理想，并发症风险低、术后恢复效果高，应推广使用该微创疗法。 　　[关键词] 腹腔镜；胆总管结石；胆道镜；临床疗效 　　[中图分类号] R657 [文献标识码] A [文章编号] 1674-0742（2016）10（b）-0070-03 　　[Abstract] Objective Discuss laparoscopic joint choledochoscope the clinical curative effect of treatment of common bile duct calculi. Methods Random choose from January 2014 to March 2016 in our hospital during the period of march in line of surgical treatment of 60 patients with common bile duct calculi， were randomly divided into control group and observation group of 30 cases each. Line in the control group of conventional laparotomy lithotomy， observation group line cut joint choledochoscope laparoscopic biliary lithotomy （LCBDE）， compared two groups of patients with intraoperative bleeding/rehydration， postoperative recovery and complications. Results Observation group of intraoperative blood loss（121.36±14.36）min， intraoperative rehydration volume（2 475.65±520.70）mL， postoperative exhaust time（20.96±5.25）h， ambulation time（14.56±4.26）h， drainage tube indwelling T time（6.69±0.68）d， postoperative hospital stay were significantly less than the control group（P 0.05）. Observation group complication rate （6.67%） was significantly lower than the control group （23.33%）， the differece was seatistically significallt（P 0.05）. Conclusion Common bile duct stones treated by laparoscopic joint choledochoscope effect is more ideal， low risk of complications， postoperative recovery effect， should promote the use of the minimally invasive treatment. 　　[Key words] Laparoscopic； Common bile duct calculi；Choledochoscope；Clinical curative effect 　　胆总管结石在肝胆外科较为常见的疾病，多由胆囊结石继发，由于结石阻