腹腔镜胆道探查术对胆囊结石合并胆总管结石疗效及安全性评价.docVIP

腹腔镜胆道探查术对胆囊结石合并胆总管结石疗效及安全性评价 　　[摘要] 目的 探讨腹腔镜胆道探查术在胆囊结石合并胆总管结石治疗中的临床疗效及安全性。 方法 148例胆囊结石合并胆总管结石患者分别行胆囊管胆道探查术（胆囊管组，26例）、胆管切开胆道探查并胆总管一期缝合（一期缝合组，65例）和胆管切开胆道探查并胆总管T管引流术（T管引流组，57例），比较三组患者的手术情况、术后恢复情况及并发症发生情况。 结果 三组患者的手术时间（F=36.789，P0.01）、术中出血量（F=13.467，P0.01）、胃肠功能恢复时间（F=29.615，P0.01）、住院天数（F=39.610，P0.01）有显著差异；一期缝合组的手术时间（t=5.76，P0.01）、术中出血量（t=4.71，P0.01）、胃肠功能恢复时间（t=6.78，P0.01）、住院天数（t=9.94，P0.01）均小于T管引流组；住院费用高于T管引流组（t=15.78，P0.01）。 结论 经胆囊管途径的腹腔镜胆道探查术的临床疗效优于腹腔镜下胆管切开后一期缝合和T管引流术。 　　[关键词] 腹腔镜胆道探查术；胆囊结石；胆总管结石 　　[中图分类号] R657.4 [文献标识码] B [文章编号] 1673-9701（2014）32-0139-03 　　The efficacy and safety of laparoscopic bile duct exploration for patients with both cholecystolithiasis and choledocholithiasis 　　LI Minxian1 XING Renwei1 LU Baochun2 　　1.Department of General Surgery，Taizhou Hospital of Zhejiang Province，Taizhou 318000，China；2.Department of General Surgery，Shaoxing Peoples Hospital of Zhejiang Province， Shaoxing 312000， China 　　[Abstract] Objective To assess the clinical efficacy and operation safety of laparoscopic bile duct exploration for patients with both cholecystolithiasis and choledocholithiasis. Methods A total of 148 patients with both cholecystolithiasis and choledocholithiasis were respectively performed the transcytic common bile duct exploration with choledochoscope （TCBDE） （TCBDE group， 26 cases）， primary duct closure group （65 cases） and T-tube drainage （T-tube group， 57 cases）， the operation situation， postoperative recovery and complications were observed among three groups. Results The operative time （F=36.789， P0.01）， blood loss （F=13.467， P0.01）， gastrointestinal function recovery time （F=29.615， P0.01）， hospital stay （F=39.610， P0.01） of three group had significant difference； the operative time （t=5.76， P0.01）， blood loss （t=4.71， P0.01）， gastrointestinal function recovery time （t=6.78， P0.01）， hospital stay （t=9.94， P0.01） of the primary duct closure group were less than the T-tube group； hospitalization costs were higher than T-tube drainage grou