摘要
目的探讨胆囊结石合并胆总管结石不同术式疗效及并发症比较。方法收集2011年3月-2015年10月我院肝胆外科收治的120例胆囊结石合并胆总管结石患者为研究对象，采用随机数字表法将患者均分为A、B、C组，A组实施腹腔镜胆囊切除术联合胆总管探查术，B组实施胆总管探查术联合传统开腹胆囊切除术，C组实施腹腔镜胆囊切除术联合内镜下Oddi括约肌切开取石术，观察比较3组围术期相关指标[手术时间、术中出血量、住院时间]、临床疗效及术后并发症情况，同时对三组患者术后复发情况进行为期1年随访。结果A、C组手术时间、术中出血量均较B组显著小（P〈0．05），A组住院时间较B、C组均显著短（P〈0．05）；A组术后临床疗效较B、C组显著高（P〈0．05）；A组术后并发症总发生率较B、C组显著低，均差异显著（P〈0．05）；三组患者术后1年均得到有效随访，A组术后1年复发率5．00％较B组的42．50％、C组的20．00％显著低，且C组1年复发率较B组显著低，均差异显著（P〈0．05）。结论腹腔镜胆囊切除术联合胆总管探查术是治疗胆囊结石合并胆总管结石的疗效确切、安全可靠的方案，值得临床推广应用。
Objective To investigate the curative effect and complications of different operative methods for the treatment of gallstone complicated with common bile duct stones. Methods 120 patients with gallstone complicated with common bile duct stones admitted in our hospital between March 2011 and October 2015 were randomized into group A, group B and group C by random number table method. Group A was treated by laparoscopic cholecystectomy combined with common bile duct exploration while group B was treated by common bile duct exploration combined with traditional open cholecystectomy and group C was treated by laparoscopic chole- cystectomy combined with endoscopic Oddi sphincterotomy. The perioperative related indicators （operation time, intraoperative blood loss, length of stay）, clinical curative effect and postoperative complications were observed and compared between groups. All patients were followed up for 1 year. Results The operation time and intraoperative blood loss of group A and group C were significantly shor- ter and less than those of group B （P 〈 0. 05）. The length of stay of group A was significantly shorter than that of group B and group C （P 〈 0. 05 ） ; The clinical curative effect in group A was significantly better than that in group B and group C （ P 〈 0. 05 ） ; The inci- dence of postoperative complications in group A was significantly lower than that in group B and group C （ P 〈 0. 05 ） ; all patients were effectively followed up for 1 year. The 1-year recurrence rate in grOUl~ A （5.00%） was significantly lower than that in group B （42. 50% ） and group C （20. 00% ）, and the 1-year recurrence rate in group C was significantly lower than that in group B （P 〈 0. 05）. Conclusion Laparoscopic cholecystectomy combined with common bile duct exploration is a safe and reliable method for the treatment of gallbladder stone complicated with common bile duct stones. It is worth to be popularized and applied.
作者
吴铁
刘敏丰
吴一峰
俞兆祉
WU Tie LIU Min-feng WU Yi-feng et al(Department of General Surgery, the ninth People＇ s Hos- pital of Wuxi, Jiangsu Provence 214062, China epartment of Hepatobiliary Surgery, the third People＇s Hospital of Wuxi, Wuxi 214041, China)
出处
《肝胆外科杂志》
2016年第6期455-457,共3页
Journal of Hepatobiliary Surgery
关键词
胆囊结石
胆总管结石
胆总管探查术
胆囊切除术
腹腔镜
Gallstone
Common bile duct stone
Common bile duct exploration
Cholecystectomy
Laparoscopic
