摘要
目的讨论腹腔镜下胆总管探查行胆管一期缝合治疗在胆总管结石合并胆囊结石临床治疗中的应用价值.方法选取2019年10月—2020年9月在该院接受手术治疗的胆总管结石合并胆囊结石患者110例为研究对象,依据手术方式将入选患者划分为两组.对照组采用胆总管切开取石联合T管引流,观察组采用胆总管探查取石并一期缝合胆管.对比两组疗效.结果观察组的并发症发生率(7.27%)低于对照组(38.18%),差异有统计学意义(P<0.05).在手术指标方面,观察组的腹腔引流时长、胃肠道功能恢复时间均短于对照组,组间差异有统计学意义(P<0.05);两组的术中出血量、手术操作时长比较,差异无统计学意义(P>0.05).在肝功能指标方面,观察组的谷氨酰转肽酶、碱性磷酸酶、丙氨酸转氨酶低于对照组,胆碱酯酶高于对照组,组间差异有统计学意义(P<0.05).结论腹腔镜下胆总管探查行胆管一期缝合治疗胆总管结石合并胆囊结石有利于加快术后胃肠道功能的恢复进程,改善患者肝功能,降低相关并发症的发生几率,治疗安全性较高.
Objective To discuss the application value of laparoscopic common bile duct exploration and primary bile duct suture in the clinical treatment of common bile duct stones combined with gallbladder stones.Methods 110 patients with common bile duct stones and gallbladder stones who underwent surgery in this hospital from October 2019 to September 2020 were selected as the research objects.They were divided into two groups according to the operation method.The control group used common bile duct incision and stone removal combined with T tube drainage,and the observation group used bile duct exploration and stone removal and primary suture of the bile duct.The efficacy of the two groups were compared.Results The incidence of complications in the observation group(7.27%)was lower than that in the control group(38.18%),and the difference was statistically significant(P<0.05).In terms of surgical indicators,the duration of abdominal drainage and the recovery time of gastrointestinal function of the observation group were shorter than those of the control group,and the differences between the groups were statistically significant(P<0.05);there were no significant differences in the amount of intraoperative blood loss and operation time between the groups(P>0.05).In terms of liver function indicators,the levels of glutamyl transpeptidase,alkaline phosphatase,and alanine transaminase of the observation group were lower than those of the control group,while the cholinesterase of the observation group was higher than that of the control group,the differences between the groups were statistically significant(P<0.05).Conclusion Laparoscopic exploration of the common bile duct and primary suture of the bile duct for the treatment of common bile duct stones combined with gallbladder stones is beneficial to speed up the recovery process of gastrointestinal function after surgery,improve the liver function of patients,reduce the incidence of related complications,and have a relatively safe treatment high.
作者
陈小军
CHEN Xiaojun(Department of Hepatobiliary Surgery,the Second People's Hospital of Zhangye City,Zhangye Gansu,734000,China)
出处
《反射疗法与康复医学》
2020年第22期57-59,共3页
Reflexology And Rehabilitation Medicine
关键词
腹腔镜
胆总管探查
胆管一期缝合
胆总管结石
胆囊结石
应用价值
Laparoscopy
Common bile duct exploration
Primary suture of the bile duct
Common bile duct stones
Gallbladder stones
Application value
