腹腔镜取石术联合内镜逆行胰胆管造影治疗胆石症78例疗效分析

摘要

Objective To analyze the effect and suitability for laparoscopic stone combined with endoscopic retrograde cholangiop-ancreatography in the treatment of 78 cases of cholelithiasis. Methods 78 patients using laparoscopic stone surgery combined with endoscopic retrograde cholangiopancreatography for treatment from June 2011 to June 2012 were set as the observation group.60 cases of patients with abdominal treatment over the same period were set as the control group. The treatment effect,wound healing and the average length of stay were observes. Results The CRP was significantly lower than the control group, the length of the incision was shorter than the control group, the average duration of hospitalization, the mean intraoperative bleeding volume was less than the control group, the difference was significant, there was statistically significance (P<0.05). There was 1 cases of pancreatitis for the observation group after surgery,and the complication rate was 1.28%.The control group had two cases of bile leakage,and the complication rate was 3.33%.The incidence of complications of the observation group was slightly lower than the control group, but the difference was with no significance,there was no statistically significance (P>0.05). Conclusion Laparoscopic lithotomy and endoscopic retrograde cholangiopancreatography in treatment of cholelithiasis is a safe and effective minimally invasive treatment method. It reduces trauma, complications on the basis of further expansion of indications for surgery in the LC, but also shortens the hospital stay.%　　目的分析腹腔镜取石术联合内镜逆行胰胆管造影治疗胆石症的临床效果.方法选择2010年6月~2012年6月上饶市立医院及上海市瑞金医院采用腹腔镜取石术联合内镜逆行胰胆管造影治疗的78例患者作为观察组,同时选择同期开腹治疗的患者60例作为对照组.观察两组治疗效果、切口愈合情况及平均住院时间.结果观察组CRP明显低于对照组,切口长度短于对照组,平均住院时间、术中平均出血量均少于对照组,两组比较差异有统计学意义(P<0.05).观察组术后出现胰腺炎1例,并发症发生率1.28%；对照组出现胆漏2例,并发症发生率3.33%,观察组并发症发生率略低于对照组,组间比较差异无统计学意义(P>0.05).结论腹腔镜取石术联合内镜逆行胰胆管造影治疗胆石症是一种安全有效的微创治疗方法,在减少创伤、并发症的基础上进一步扩大了腹腔镜胆囊切除术(Laparoscopic Cholecystectomy,LC)的手术指征,而且缩短了住院时间.