腹腔镜、胆道镜及选择性十二指肠镜联合手术治疗胆囊结石合并胆总管结石

摘要

Objective To study the effect of laparoscopy,choledochoscopy and selective duodenoscopy in the treatment of cholecystolithiasis complicated with choledocholithiasis.Methods From April 2015 to April 2017,58 patients complicated with cholecystolithiasis and choledocholithiasis were treated in our hospital,who were randomly divided into the observation group(29 cases)and the control group(n＝29).The observation group was treated with laparoscopy,choledochoscopy and selective duodenal endoscopy,while the control group was treated with lapa-roscopy combined with duodenoscopy.The curative effect,operation and hospitalization time,intraoperative blood loss,VAS score and complications were compared between the two groups.Results It was significantly lower of the numerical value of operation time and hospitalization time,bleeding volume and intestinal recovery time of the observation group than that of the control group(P＜0.05).The total clearance rate of calculi in the observation group was significantly higher than that of the control group(P＜0.05).And there was no significant difference in the incidence of postoperative complications between the two groups(all P＞0.05).Conclusion The combined application of laparoscopy,choledochoscopy and selective duodenoscopy for the treatment of cholecystolithiasis and choledocholithiasis patients can not only reduce operative time,hospitalization time and the amount of bleeding,but also can increase the stone clearance rate,which is worthy of clinical promotion.%目的 研究腹腔镜、胆道镜及选择性十二指肠镜联合应用对胆囊结石合并胆总管结石患者的疗效.方法 我院从2015年4月到2017年4月有58例胆囊结石合并胆总管结石患者就诊.以数字表法随机分成观察组(29例)和对照组(29例).其中观察组给予腹腔镜、胆道镜及选择性十二指肠镜联用术式治疗,对照组给予腹腔镜联合十二指肠镜术式治疗.结果 观察组患者手术时间和住院时间,术中出血量以及术后肛门恢复通气时间均显著少于对照组;观察组患者结石完全清除率显著高于对照组(均P＜0.05);两组患者术后并发症发生率差异无显著意义(均P＞0.05).结论 腹腔镜、胆道镜及选择性十二指肠镜联用术式对胆囊结石合并胆总管结石患者不仅有效降低患者手术时间、住院时间,减少出血量等,还能提高结石清除率,减少并发症,值得临床推广.