摘要
目的观察腹腔镜联合胆道镜保胆取石术治疗胆囊结石的临床疗效。方法将我科收治的158例胆囊结石患者随机分为观察组和对照组,每组79例。观察组行腹腔镜联合胆道镜保胆取石术,对照组行腹腔镜胆囊切除术,比较两组手术情况及相关并发症的发生情况。结果两组术后均取得满意疗效,无中转开腹治疗病例,术后2 w复查结石均取净;两组在手术时间、术中出血量、术后胃肠功能恢复时间、肛门排气时间及住院时间方面无显著差异(P>0.05);两组术后均未出现胆瘘、出血等严重并发症。观察组术中胆管损伤,术后胆汁反流性胃炎、腹胀、腹泻发生率明显低于对照组(P<0.05);两组术后胆总管结石发生率未见明显差异(P>0.05)。结论腹腔镜联合胆道镜保胆取石术治疗胆囊结石临床疗效确切,保留了胆囊的功能,且并发症少,具有良好的安全性,值得临床推广和进一步研究。
To observe the clinical effects of laparoscopy combined with choledochoscopic gallbladder-preserving cholelithotomy on cholecystolithiasis. Total 158 patients with cholecystolithiasis to receive treatment in our department were randomly divided into observation group and control group （n = 79 per group）. The observation group received laparoscopy combined with choledochoscopic gallbladder-preserving cholelithotomy, and the control group received laparoscopic cholecystectomy; the＆amp;nbsp;operation status and complications between two groups were compared. The curative effects in both groups were satisfactory after the operation, with no conversion to laparotomy, and it was found that the stones had been completely removed according to the examination in 2 w after the operation; there was no significant difference in the operation time, intraoperative bleeding volume, postoperative gastrointestinal function recovery time, anal exhaust time and hospitalization time between two groups （ P〈0.05）; there were no serious complications, such as biliary fistula and hemorrhage after the operation in both groups. The incidences of postoperative bile duct injury and bile reflux gastritis, abdominal distension and diarrhea in the observation group were significantly lower than those in the control group （ P〉 0.05）, but the incidence of postoperative common bile duct calculi showed no significant difference between the two groups （ P〈0.05）. Laparoscopy combined with choledochoscopic gallbladder-preserving cholelithotomy has definite clinical curative effect in the treatment of cholecystolithiasis; it retains the function of gallbladder and has fewer complications and good safety, and is worthy of clinical promotion and further research.
出处
《西南国防医药》
CAS
2015年第6期613-616,共4页
Medical Journal of National Defending Forces in Southwest China
关键词
腹腔镜
胆道镜
胆囊结石
保胆取石
laparoscopy
choledochoscopy
cholecystolithiasis
gallbladder-preserving cholelithotomy
