腹腔镜及传统开腹手术治疗胆总管结石临床应用比较分析.doc

腹腔镜及传统开腹手术治疗胆总管结石临床应用比较分析作者单位：523945 广东医学院附属厚街医院 通讯作者：万德培 【摘要】 目的 探讨腹腔镜胆道探查取石术与传统开腹手术治疗胆总管结石的临床疗效。方法 将笔者所在医院2008年12月～2009年7月收治的胆管结石患者50例随机分为观察组和对照组，每组25例。观察组采用腹腔镜胆道探查取石术治疗，对照组采用传统开腹手术治疗，比较两组患者的手术操作时间、术中出血量、术后胃肠功能恢复时间、住院时间及术后并发症。结果 观察组在术中出血量、术后胃肠功能恢复时间、住院时间及术后并发症方面均显著优于对照组（P＜0.01）。两组手术时间差异无统计学意义（P＞0.05）。结论 腹腔镜胆道探查取石术是安全可行的，其创伤小、痛苦少、恢复快，值得临床推广。 【关键词】 腹腔镜； 传统开腹； 胆总管结石； 疗效 Comparative analysis of laparoscopic and traditional open surgery in treatment of bile duct stones WANG De-pei.Afflicted Houjie Hospital of Guangdong medical college,Guangdong 523945,China 【Abstract】 Objective To explore laparoscopic biliary exploration take nephrolithotomy with traditional open surgery treatment bravery manager clinical curative effect.Methods To our hospital from December 2008 to July 2009 were treated 50 patients with bile duct stones were randomly divided into two groups and the control group, N 25 in the observation group with laparoscopic treatment of bile duct stone exploration, The control group treated with traditional open surgery, Two groups were compared operative time, blood loss, postoperative recovery of gastrointestinal function, hospitalization time and postoperative complications.Results The results of the treatment group blood loss, postoperative recovery of gastrointestinal function, hospitalization time and postoperative complications were significantly better than the control group, P 0.05.Conclusion Lithotomy laparoscopic bile duct exploration is safe and feasible, the trauma, less pain, faster recovery and is worthy of promotion. 【Key words】 Laparoscopy; Traditional laparotomy; Common bile duct stone; Effect 近年来，随着腹腔镜技术的发展与推广，其具有的创伤小、恢复快和并发症少等优点，同时避免了开腹手术对患者生理及心理造成的不良影响，腹腔镜取代开腹手术已成为一种趋势［1］。笔者所在医院2008年12月～2009年7月采用腹腔镜胆囊切除术治疗25例肝胆管结石疗效满意，报告如下。 1 资料与方法 1.1 一般资料 本组患者50例，均为笔者所在医院收治的胆总管结石患者，术前均经B型超声波（BUS）、逆行胰胆管造影（ERCP）及核磁共振胰胆管造影（MRCP）确诊。其中男27例，女23例。年龄18～78岁，平均（42.2±3.5）岁。病程4 h～14 d，大部分有反复右上腹疼痛病史，胆总管内可扪及结石。B超示胆囊内光团及其后方的声影，有萎缩性改变。胆总管结石位于上段的26