腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石52例临床疗效观察

腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石52例临床疗效观察

收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2012-08-25

Clinical Observation Of 52 Patients Of Cholecystolithiasis And Choledocholithiasis Using Laparoscopy Combined With Choledochoscopy

Received:1900-01-01 Revised:1900-01-01 Online:2012-08-25

摘要/Abstract

摘要： 目的:探讨腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床疗效。方法:本实验组的52例均为我院2008年1月～2011年1月收治的胆囊结石合并胆总管结石患者,采用腹腔镜联合胆道镜治疗。对照组为常规胆囊胆总管切开取石术的52例患者。对两组患者的治疗情况、并发症发生情况、残留结石情况进行比较。结果:实验组患者手术均得到成功,无中转开腹,其中T管引流32例,胆总管一期缝合20例。实验组患者的手术时间与对照组相比差异无统计学意义(P>0.05),术中出血量、住院时间均显著短于对照组(P<0.05)。实验组有1例患者并发胰腺炎,经对症治疗后缓解。有5例患者发生胆汁瘘,经引流后好转。对照组发生肺部感染6例,切口感染3例。随访1年,实验组发现残余结石2例,经胆道镜取石后痊愈。两组患者均未见结石残留。结论:腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石,适用于胆结石过大的患者,是一种可靠的微创手术治疗方法,值得临床上推广使用。

Abstract: Objective:To discuss clinical curative effect of cholecystolithiasis and choledocholithiasis using laparoscopy combined with choledochoscopy.Methods:The experimental group of 52 cholecystolithiasis and choledocholithiasis patients came from our hospital from January 2008 to January 2011,using laparoscopy combined with choledochoscopy.52 patients of controlling group used conventional cholecystectomy choledocholithotomy.The treatment,complications,residual stones were compared between two groups.Results:The operation of experimental group patients were all successful,and had no one conversing to open surgery.32 cases had T tube drainage,and 20 cases had primary suture of common bile duct.The difference of operation time of experimental group patients was not statistically significant(P>0.05) compared with the control group,and the amount of intraoperative blood loss and hospital stay of experimental group was significantly shorter than that in control group(P<0.05).The experimental group had 1 patients complicated with pancreatitis,and recovered after symptomatic treatment.There are 5 cases with biliary fistula who improved by drainage.6 patients of the control group had pulmonary infection,and 3 case of incision infection.Following up of 1 years,the experimental group showed residual calculi in 2 cases,and recovered by removal of gallstones with choledochoscope.Two groups of patients showed no residual stones.Conclusion:The treatment of laparoscopy combined with choledochoscopy for common bile duct stone complicated with gallstones was applicable to patients of large stone,and it was a reliable minimally invasive operation treatment which was worthy of clinical use.

. 腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石52例临床疗效观察[J]. .

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