胆道镜辅助腹腔镜治疗高龄肝胆管结石患者的临床疗效

摘要

目的：探讨胆道镜联合腹腔镜治疗高龄胆管结石患者的临床疗效。方法：113例高龄胆总管结石患者给予胆道镜辅助腹腔镜治疗，回顾性分析其临床资料。年龄≥70岁41例(高龄组)，＜70岁72例(非高龄组)，对两组患者的中转开腹率、手术时间、术中失血量、胃肠道功能恢复时间、住院时间、术后胆道残留结石率等指标进行分析。结果：高龄组顺利完成手术37例，中转开腹4例(10.8%)；非高龄组顺利完成手术66例，中转开腹6例(8.3%)；两组其他指标比较，差异均无统计学意义(P＞0.05)。结论：腹腔镜联合胆道镜治疗胆管结石具有安全、有效、损伤小、恢复快等优点，适合高龄患者，术者需要熟练的操作技能。%Objective:To explore the clinical curative effect of choledochoscope combined with laparoscope in the treatment of hepatic calculus in elderly patients.Methods:113 patients with hepatic calculus were given choledochoscope assisted laparoscope treatment.The clinical data were retrospectively analyzed.The age was more than or equal 70 years old in 41 cases(the elderly group);the age was less than 70 years old in 72 cases(the non elderly group).The transfer laparotomy rate,operation time,intraoperative blood loss,gastrointestinal function recovery time,hospitalization time,postoperative biliary residual stone rate of patients were analyzed.Results:37 cases were successfully completed surgery in the elderly group;4 cases(10.8%) were transfer laparotomy.66 cases were successfully completed surgery in the non elderly group;6 cases(8.3%) were transfer laparotomy.The other indexes of two groups were compared,and the differences were not statistically significant(P > 0.05).Conclusion:Laparoscope combined with choledochoscope in treatment of hepatic calculus has the advantages of safe and effective,less damage and fast recovery.It is suitable for elderly patients and the operator need skilled operational skills.