摘要
目的探讨腹腔镜胆总管探查术对胆囊切除术后胆总管结石患者康复和疗效的影响。方法收集我院2016年3月~2018年3胆囊切除术后胆总管结石患者97例进行研究,其中采用腹腔镜胆总管探查术治疗的51例患者设为观察组,采用开腹胆总管探查术治疗的46例患者设为对照组,比较两组患者的围术期指标,治疗前、治疗4周后血清γ-谷氨酰转肽酶(GGT)、碱性磷酸酶(ALP)水平变化,术后并发症发生情况及手术疗效。结果与对照组比较,观察组的手术时间、术中出血量、术后排气时间、术后禁食时间及住院时间均明显减少,两组的血清GGT及ALP水平均明显降低,且观察组低于对照组,差异均有统计学意义(P<0.05);观察组总并发症发生率为23.53%,明显低于对照组的65.22%,观察组的手术成功率94.12%,高于对照组的71.74,差异均有统计学意义(P<0.05)。结论与开腹胆总管探查术比较,腹腔镜胆总管探查术治疗胆囊切除术后胆总管结石患者可有效减少术中出血量,缩短手术时间、术后排气时间、术后禁食时间及住院时间,减少并发症的发生,提高手术成功率,相对减少结石残留及结石复发,进而改善患者预后。
Objective To explore the effect of laparoscopic common bile duct exploration on the recovery and efficacy of patients with common bile duct stones after cholecystectomy.Methods 97 patients with common bile duct stones after cholecystectomy treated in our hospital from March 2016 to March 2018 were collected.Among them,51 patients treated with laparoscopic common bile duct exploration were set as observation group,and 46 patients treated with open common bile duct exploration were set as control group.The perioperative indicators of the two groups,changes in serumγ-glutamyl transpeptidase(GGT)and alkaline phosphatase(ALP)levels before and after 4 weeks of treatment,postoperative complications,and surgical efficacy were compared between the two groups.Results Compared with the control group,the operation time,intraoperative blood loss,postoperative exhaust time,postoperative fasting time and length of hospital stay were significantly reduced in the observation group.Serum GGT and ALP levels were significantly reduced in the two groups,and the observation group was lower,and the differences were statistically significant(P<0.05).The total complication rate in the observation group was 23.53%,which was significantly lower than 65.22%in the control group;the operation success rate in the observation group was 94.12%,which was higher than 71.74%in the control group,and the differences were statistically significant(P<0.05).Conclusion Compared with open common bile duct exploration,laparoscopic common bile duct exploration can effectively reduce the amount of intraoperative bleeding,shorten the operation time,postoperative exhaustion time,postoperative fasting time and hospital stay for patients with common bile duct stones after cholecystectomy.It can also reduce the occurrence of complications,improve the success rate of surgery,relatively reduce the residual stones and recurrence of stones,and thus improve the prognosis of patients.
作者
陈芳英
林莉
张鸣杰
CHEN Fangying;LIN Li;ZHANG Mingjie(Department of Hepatobiliary and Pancreatic Surgery,Huzhou Central Hospital in Zhejiang Province,Huzhou,313000,China)
出处
《中国现代医生》
2020年第19期50-53,共4页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2017ZH020)。
关键词
腹腔镜胆总管探查术
开腹胆总管探查术
胆囊切除术后胆总管结石患者
疗效
预后
Laparoscopic common bile duct exploration
Open common bile duct exploration
Patients with common bile duct stones after cholecystectomy
Efficacy
Prognosis
