腹腔镜联合胆道镜治疗胆总管结石的分析-腹部腔镜外科专业论文.docxVIP

青海大学医学院 青海大学医学院 2010 级攻读临床医学硕士学位研究生毕业论文 Laparoscope Combined with Choledochoscope Analysis of Treatment of Common Bile Duct Calculi Postgraduate :YangShenghu Directed by : PROF.DengYong PROF.QinWei ABSTRACT Objectives：Discuss laparoscopic joint choledochoscope for treatment of common bile duct calculi. Methods：In our hospital ,40 cases of common bile duct stones in patients (20 males and 20 females; aged 39-50 years, mean 45 years; 2 months- 10 years history, an average of 4 years) were randomly divided into laparoscopic group and control group. laparoscopic group received laparoscopic biliary lithotomy, the control group received traditional open stone surgery, patients were observed intraoperative and postoperative complications. Results ： Laparoscopic operation time, intraoperative blood loss, postoperative exhaust time, postoperative hospital stay were lower than the control group, comparing differences between groups was statistically significant (p ＜ 0.05 or p ＜ 0.01); Incision pain and infection rates in laparoscopic group was obviously lower than the control group, comparing differences between groups was statistically significant (p ＜ 0.01). Conclusion： Laparoscope combined with choledochoscope in common bile duct calculi treatment safe and reliable, and patients with small trauma, fast recovery of obvious characteristics. Laparoscope combined with choledochoscope in the treatment of common bile duct stones in patients with shorter operation time, less intraoperative blood loss, earlier postoperative exhaust time, postoperative hospitalization time, worthy of clinical popularization and application. Key words：Laparoscope; Choledochoscope; Common bile duct calculi; Minimally invasive treatment 第 第 PAGE 10 页 共 18 页 前 言 胆总管 HYPERLINK /view/25353.htm 结石是指位于胆总管内的结石，根据其来源可分为原发性胆总管结 石和来自胆囊的继发性胆总管结石。胆总管结石的临床表现及病情的轻，重， 危，完全取决于结石阻塞时的程度和有无胆道感染。发作时阵发性上腹部绞痛， 寒战发热和黄疸三者并存（Charcot 三联征），是结石阻塞继发胆道感染的典型 表现。由于胆汁滞留， HYPERLINK /view/2177773.htm 胆总管扩张，加之胆囊的收缩，胆总管的蠕动，可使结 石移位或排