摘要
目的探讨腹腔镜、胆道镜与十二指肠镜联合治疗复杂肝外胆管结石的临床效果。方法方便选取2017年7月—2018年12月该院收治的120例复杂肝外胆管结石患者作为研究对象,将其中64例行腹腔镜、胆道镜与十二指肠镜联合治疗的患者作为观察组,另56例行腹腔镜联合胆道镜治疗的患者作为对照组,比较两组患者的临床疗效。结果经对比分析,观察组除手术时间长于对照组外,在手术成功率、治疗有效率、术中失血量、肠鸣音恢复时间、首次排气时间、首次下床活动时间及住院时间方面均优于对照组,组间差异有统计学意义(P<0.05),观察组在结石残留率方面与对照组相当,组间差异无统计学意义(P>0.05)。观察组术后并发症发生率1.56%,对照组术后并发症发生率10.71%,组间差异有统计学意义(χ^2=7.269,P=0.007)。结论三镜(腹腔镜、胆道镜、十二指肠镜)是目前治疗复杂肝外胆管结石一种安全有效的方法,整体临床应用价值优于腹腔镜、胆道镜联合治疗,该方法值得在临床借鉴并进一步发展以深化其价值。
Objective To explore the clinical effect of laparoscopy,choledochoscopy and duodenoscope in the treatment of complex extrahepatic bile duct stones.Methods 120 patients with complicated extrahepatic bile duct stones admitted to the undergraduate department from July 2017 to December 2018 were taken as the research object,and 64 patients who underwent laparoscopy,choledochoscopy and duodenoscope were treated as the observation group.In addition,another 56 patients undergoing laparoscopy combined with choledochoscopy were used as a control group,and the clinical efficacy of the two groups was compared.Results After comparative analysis,the observation group of the operation time being longer than the control group,the operation success rate,treatment efficiency,intraoperative blood loss,bowel sound recovery time,first exhaust time,first time out of bed activity and hospitalization time were better than the control group.The difference was statistically significant(P<0.05).The observation group had the same residual stone rate as the control group,and there was no statistically significant difference between the groups(P>0.05).The incidence of postoperative complications in the observation group was 1.56%,and the incidence of postoperative complications in the control group was 10.71%.The difference between the groups was statistically significant(χ^2=7.269,P=0.007).Conclusion Three mirrors(laparoscopy,choledochoscopy,duodenoscopy)is a safe and effective method for the treatment of complex extrahepatic bile duct calculi.The overall clinical application value is better than the combined treatment of laparoscopy and choledochoscopy.This method is worthy of clinical reference and further development to deepen its value.
作者
冯石坚
陈贵俦
梁宏伟
FENG Shi-jian;CHEN Gui-chou;LIANG Hong-wei(Department of General Surgery,Yangjiang People's Hospital,Yangjiang,Guangdong Province,529500 China)
出处
《中外医疗》
2020年第18期77-79,共3页
China & Foreign Medical Treatment
关键词
复杂肝外胆管结石
腹腔镜
胆道镜
十二指肠镜
疗效
Complex extrahepatic bile duct stones
Laparoscopy
Choledochoscope
Duodenoscope
Efficacy
