摘要
目的 比较5年来腹腔镜胆囊切除术（LC）和腹腔镜联合胆道镜保胆取石术（LCCC）治疗胆囊结石的疗效.方法 将400例胆囊结石患者,在知情同意的情况下分为LCCC组（200例）和LC组（200例）.对两组的手术时间、术后住院时间、住院费用、术后症状和结石复发等因素进行分析.结果 LCCC组与LC组比较,手术时间长[（53.6±15.2） min与（29.4±10.8） min,P＜0.05）];术后住院时间差异无统计学意义.两组术后随访5年,平均3.8年.正常饮食情况下,LCCC组无腹泻症状,LC组术后出现腹泻症状者110例（55%）,差异有统计学意义（P＜0.01）,患者必须服用低脂饮食以缓解腹泻症状.技术开展初期（3个月）,经复查B超发现LCCC组结石残留4例（2%）,复发结石4例（2%）.两组住院费用差异无统计学意义.结论 LCCC较LC手术时间稍长,术后住院时间无明显差异.保胆手术复发和结石残留率低,无胆囊切除后的腹泻症状.保胆手术保留了患者的器官,值得进一步探索.
Objective Iaparoscopic cholecystectomy（LC） is a routine procedure for gallbladder stone,cholecystolithotomy（LCCC） is recently a new method. Clinical outcome of LCCC and LC were compared. Methods A prospective, randomized, no-blind clinical oberservation were carried out. 200 patients with gallbladder stones were divided into LCCC group （100 cases） and LC group （100 cases）. Operative time, postoperative inpatient time and postoperative symptoms and relapse were documen- ted. Results The operative time of the LCCC was longer than LC [（53.6 ± 15.2） min VS （29. 4 ± 10. 8） rain, P〈0. 05]. No differences were found on postoperative time and other immediate complica- tions. Patients were followed up 5 years, 110 cases of diarrhea（55%） were found in the LC group in compare with none in the LCCC group （P〈0.05）; 4 cases of relapse and 4 cases of residual were found in the LCCC group in compare with none in the LC group. The cost of each group is the same. Conclusion LCCC takes more time than LC but has no diarrhea and other complications, with no differences on postoperative stay and other clinical data. Postoperative diarrhea occurs in 55% of pa- ttens with LC while none in LCCC. Although LCCC preserves the organ and is beneficial, it is warran- ted to carry out more study.
出处
《腹部外科》
2013年第5期329-332,共4页
Journal of Abdominal Surgery
关键词
胆囊结石病
胆囊切除术
腹腔镜
腹腔镜联合胆道镜保胆取石
Cholecystolithiasis
Cholecystolithotomy,laparoscopic
Laparoscopic combined cho ledoscopic cholecystolitbotomy
