腹腔镜联合纤维胆道镜治疗胆囊胆总管结石
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傅侃达E-mail:changjiangqin2003@yahoo.com.cn

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Laparoscopic cholecystectomy combined with choledochoscopy in treatment of cholecystolithiasis and choledocholithiasis
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    摘要:

    目的:探讨腹腔镜联合胆道镜治疗胆囊结石胆总管结石的效果。
    方法:将2005年6月—2009年6月收治的168例胆囊结石合并胆总管结石患者,随机抽取90例行腹腔镜胆囊切除+胆总管切开+胆道镜探查、取石T管引流术(联合腹腔镜组),另78例行开腹胆囊切除+胆总管切开取石T管引流术(对照组),对比分析两组的临床效果。
    结果:开腹组并发症发生率高于联合组(P<0.05),联合组住院时间、胃肠功能恢复时间均短于对照组(P<0.05),两组手术时间、住院费用差异无统计学意义(P>0.05)。
    结论:与传统开腹手术相比,用腹腔镜联合胆道镜治疗胆囊胆总管结石具有创伤小、恢复快、住院时间短等优点,优于传统开腹手术。

    Abstract:

    Objective: To investigate the value of laparoscopy combined with choledochoscopy in treatment of cholecystolithiasis complicated with choledocholithiasis.
     Methods: Clinical data of 168 patients with  cholecystolithiasis and choledocholithiasis treated in our haspital from June 2005 to June 2009 were analysed. Ninety patients were randomly selected and treated by laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage (group A), the other 78 patients, as control group, underwent routine cholecystectomy and choledocholithotomy plus T-tube drainage by laparotomy (group B).
     Results: The hospital stay and the mean time to passage of flatus in group A was much shorter than that in group B (P<0.05); and the postoperative complication rate in group A was obviously lower than that in group B(P<0.05); while  the mean operative time and cost of hospitalization between the two groups had no statistical difference(P>0.05).
     Conclusions: Laparoscopic cholecystectomy combined with choledocholithotomy and T-tube drainage for cholecystolithiasis and choledocholithiasis is a microtrauma management with advantages of quick recovery and shorter hospital stay, that makes it superior to the open operation.

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傅侃达|秦长江|任学群.腹腔镜联合纤维胆道镜治疗胆囊胆总管结石[J].中国普通外科杂志,2010,19(2):128-131.
DOI:10.7659/j. issn.1005-6947.2010.02.006

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  • 收稿日期:2010-01-06
  • 最后修改日期:2010-01-22
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  • 在线发布日期: 2010-02-15