完全腹腔镜保胆取石术与腹腔镜辅助胆道镜保胆取石术的临床对比研究

摘要

目的:研究完全腹腔镜保胆取石术、腹腔镜辅助胆道镜保胆取石术的优缺点,探讨其临床应用的可行性、优越性及手术技巧.方法:2008年8月至2009年2月由同一术者施术,完全腹腔镜保胆取石术(对照组)28例,腹腔镜辅助胆道镜保胆取石术(观察组)30例,对比分析两组手术时间、术中出血量、术后肠蠕动恢复时间、术后并发症、住院时间及术后随访情况.结果:58例患者均顺利完成手术,并取净结石.观察组平均手术时间及术中出血量少于对照组(P<0.05).术后肠蠕动恢复时间、住院时间两组差异无统计学意义.两组术后均无并发症发生,随访6～12个月,未发现结石复发.结论:腹腔镜辅助胆道镜保胆取石术安全可行,具有手术时间短、术中出血少等优点.但两种术式的远期疗效尚需深入研究和对比观察.%Objective :To discuss the advantages and disadvantages of totally laparoscopic cholecystolithotomy (TLC)or celioscopic-assisted choledochoscopic cholecystolithotomy ( CCC), and explore the possibilities, superiority and surgical technique of their clinical application. Methods:The clinical data of 28 patients with TLC (controlled group) and 30 patients with CCC (observed group)performed by the same surgeon between Aug. 2008 and Feb. 2009 were analyzed. The operation time, bleeding volume during it, enterokinesia recovery time,post-operative complication, hospital stay and follow-up were compared between two groups. Results:All opera .tions were successful with complete stone clearance. The operation time and bleeding volume in observed group were significantly less than controlled group(P ＜ 0.05). But the differences of enterokinesia recovery time and hospital stay between two groups were not significant in statistics. No post-operative complication occurred. All patients were followed up for 6-12 months with no stone recurrence.Conclusions: CCC is a safe, efficient and feasible procedure with less operation time and bleeding volume. Long-term effects of two procedures need further analysis and comparative study.