腹腔镜下经胆囊管治疗继发胆总管结石的疗效分析

Clinical analysis of laparoscopic surgery for secondary bile duct stones via cystic duct

摘要:

目的 分析腹腔镜下经胆囊管治疗继发胆总管结石的临床疗效。方法 选取在该院接受治疗的胆结石继发胆总管结石的患者120例，按照随机的方法平均分给观察组与对照组，每组60例患者。观察组实施腹腔镜下经胆囊管治疗继发胆总管结石的方法治疗，对照组采用传统的腹腔镜下胆总管探查T管引流术。治疗一段时间后，比较两组患者的手术时间、胃肠功能恢复时间、术中出血情况、并发症的总发生率和住院时间。结果 观察组的术中手术时间、胃肠功能恢复时间、术中出血情况、并发症的发生率和住院时间均少于对照组；其中观察组在住院时间（5.4±2.1）d明显低于观察组（16.5±6.9）d，术后水、电解质紊乱、伤口疼痛和感染等并发症总发生率（6.66%）明显低于对照组的总发生率（61.67%），差异具有统计学意义（P <0.05）。结论 腹腔镜下经胆囊管治疗胆结石合并胆总管结石优于传统的腹腔镜下胆总管探查T管引流术，术中的出血量少、更安全且并发症少，恢复快，建议广泛使用。

Abstract:

Objective To analyze the clinical efficacy of laparoscopic surgery for secondary bile duct stones via cystic duct. Methods 120 patients with secondary bile duct stones were randomly divided into observation group and control group, 60 patients in each group. Observation group implemented the method of Laparoscopic through the cystic duct treatment of secondary common bile duct stones for treatment, control group used traditional laparoscopic common bile duct exploration of T-tube drainage. After a period of treatment, compared the surgery time, gastrointestinal function recovery time, blood loss, the overall incidence of complications and hospitalization time between the two groups. Results The operative time, gastrointestinal function recovery time, blood loss, the incidence of complications and hospitalization time in observation group were less than that in control group; observation group: hospitalization time (5.4 ± 2.1) d, significantly lower than control group: (16.5 ± 6.9) d. After surgery, water, electrolyte imbalance, wound pain, infections and other complications (6.66%) was significantly lower in observation group than that in control group: the overall rate (61.67%), there was statistical significance (P < 0.05). Conclusions Laparoscopic surgery for secondary bile duct stones via cystic duct is superior to the common bile duct exploration of T-tube drainage under traditional laparoscopy, which is less intraoperative bleeding, safer and less complications and faster recovery, it is recommended widely promotion.