摘要
目的:探讨经腹腔镜联合电子胆道镜胆道治疗胆道多发结石的可行性并比较其与常规开腹手术治疗胆道多发结石的临床疗效。方法:106例多发胆道结石患者分为腹腔镜联合电子胆道镜组(L组)67例与常规开腹手术治疗组(O组)39例。L组患者施行经腹腔镜辅助的电子胆道镜探查胆管取石手术,O组患者施行常规的开腹探查胆道取石手术,术中辅助胆道造影或胆道镜检查,比较2组患者的手术时间、住院费用、住院天数、术后消化道功能恢复时间、胆道并发症[术中及术后出血、胰腺炎、术后胆道感染、结石残留和(或)复发]发生率。结果:L组与O组的手术均成功,L组无中转手术,2组无死亡病例。2组手术时间分别为人民币(135.8±12.7)min、(118.8±10.9)min;住院费用分别为人民币(1.36±0.22)万元、(1.18±0.17)万元,P>0.05。住院天数分别为(7.6±0.7)d、(13.7±1.2)d;术后消化道功能恢复时间分别为(28.5±2.3)h、(50.6±4.8)h;胆道并发症发生率分别为7.5%、17.9%,均P<0.05。结论:胆道多发结石的患者仍可一次性施行经腹腔镜辅助的电子胆道镜胆道探查取石术,且较常规开腹手术更具优越性。
Objective：To study the clinical probability of choledocholithotomy by laparoscopy-assisted choledochoelectroscopy for patients with multiple bile duct stones and compare its effect with the procedure of open bile duct exploration.Methods：A total of 106 patients with multiple bile duct stones were divided into two groups,the laparoscopy-assisted choledochoelectroscopy（Group L） 67 patients and open bile duct exploration（Group O） 39 patients.In Group L,the patients were performed laparoscopic cholecystectomy（LC） and choledocholithotomy by laparoscopy-assisted choledochoelectroscopy directly,but in Group O,the patients were performed open bile duct exploration and then cholangiography.Compared the two groups patients＇ operation time,costs,in hospital days,time of digestive function recovery,the rate of biliary complications including bleeding or infection,or pancreatitis,or stone recur and residual.Results：All operations were succeeded,no death case in two groups.In Group L and Group O,operation time were（135.8±12.7）min and（118.8±10.9）min,respectively.The costs were（1.36±0.22） and（1.18±0.17） ten thousand yuan,respectively.（all P0.05）.In hospital days were（7.6±0.7）d and（13.7±1.2）d,time of digestive function recovery were（28.5±2.3）h and（50.6±4.8）h,the rate of biliary complications were 7.5% and 17.9% respectively.（all P0.05）.Conclusions：Choledocholithotomy by laparoscopy-assisted choledochoelectroscopy can also be performed directly in patients with multiple bile duct stones,when compared with traditional open procedure it presents more predominances.
出处
《中国临床医学》
2011年第3期341-343,共3页
Chinese Journal of Clinical Medicine
基金
上海市奉贤区科委基金资助项目(编号:2008-01-13)
关键词
腹腔镜
胆道镜
胆道结石
胆道探查术
Laparoscope
Choledochoelectroscope
Cholelithiasis
Exploration of bile duct
