腹腔镜与十二指肠乳头切开取石术治疗胆总管结石临床探讨.docVIP

腹腔镜与十二指肠乳头切开取石术治疗胆总管结石临床探讨 　　[摘要] 目的 探讨腹腔镜胆总管探查术与十二指肠乳头切开取石术治疗胆总管结石的临床疗效及安全性。 方法 将随机选取2011年8月―2014年8月在该院接受胆总管结石手术的120例胆总管结石患者分为观察组和对照组各60例，其中观察组行腹腔镜胆总管探查术治疗，对照组采用十二指肠乳头切开取石术方案，比较2组手术指标，并评价预后情况。 结果 2组手术成功率、中转开腹率和结石残留率对比差异无统计学意义（P0.05），但术后并发症发生率对比差异有统计学意义（P0.05）。2组远期结石复发率和并发症发生率对比差异有统计学意义（P0.05）。结论 腹腔镜胆总管探查切除手术治疗胆总管结石具有显著的微创优势，创伤小，术后微创功能恢复快。不过临床应根据患者特点及手术适应症选择合适的术式。 　　[关键词] 腹腔镜探查术；十二指肠乳头切开取石术；胆总管结石；复发；疗效 　　[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2015）09（c）-0025-03 　　[Abstract] Objective To explore the clinical efficacy and safety of laparoscopic common bile duct exploration and endoscopic sphincterotomy in the treatment of choledocholithiasis. Methods 120 cases underwent choledocholithiasis surgery in our hospital from August 2011 to August 2014 were divided into the observation group and the control group with 60 cases in each. Patients in the observation group were treated by laparoscopic common bile duct exploration， while those in the control group were treated by endoscopic sphincterotomy. And the surgical indexes of the two groups were compared， and the prognosis of the patients was evaluated. Results The differences in the surgical success rate， rate of changing to laparotomy and stone residual rate between the two groups were not statistically significant（P0.05）. There was statistically significant difference in the incidence of postoperative complications between the two groups（P0.05）. Statistically significant differences were found in the long-term stone recurrence rate and incidence of complications between the two groups（P0.05）. Conclusion Laparoscopic common bile duct exploration has significant advantage of minimally invasion， and quick postoperative recovery of minimally invasive function， but the operation should be selected in accordance with the conditions of the patients and surgical indication. 　　[Key words] Laparoscopic exploration； Endoscopic sphincterotomy； Choledocholithiasis； Recurrence； Efficacy 　　胆总管结石是临床极为常见的胆道系统疾病，好发于中老年人群，近年来发生率呈快速上