胆道镜联合腹腔镜手术与常规开腹手术治疗老年肝胆管结石效果比较

摘要

Objective To compare the efficacies between choledochoscopy combined with laparoscopy and conventional laparotomy surgery in the treatment of elderly patients with hepatobiliary calculi. Methods Totally 92 elderly patients with hep-atobiliary calculi in our hospital from Jan. 2012 to June 2014 were selected and randomly divided into the control group and the observation group,46 cases in each group. The control group was given the conventional laparotomy surgery ,while the observation group was given choledochoscopy combined with laparoscopy. The operation time ,intraoperative bleeding amount,postoperative anal exhaust time,postoperative hospitalization days and postoperative complications were compared between the two groups. Results (1)The operation time,intraoperative bleeding amoun,postoperative anal exhaust time and hospitalization days in the observation group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05). (2)The incidence rate of postoperative complications in the observation group was significantly lower than that in the control group,the difference was statistically significant (χ2=8.963,P=0.024). (3) The postoperative total effective rate in the observation group was 95.7%(44/46),which was significantly higher than 78.3%(36/46) in the control group,the difference was statisti cally significant(χ2=18.784,P=0.004). Conclusion Choledochoscopy combined with laparoscopy in the treatment of elderly pa-tients with hepatobiliary calculi can effectively enhance the clinical efficacy and reduce postoperative complications,which is worth widely applying in clinic.%目的 比较胆道镜联合腹腔镜手术与常规开腹手术治疗老年肝胆管结石的效果.方法 选取2012年1月至2014年12月该院收治的老年肝胆管结石患者92例,随机分为对照组和观察组,各46例.对照组给予常规开腹手术,观察组给予胆道镜联合腹腔镜手术.比较两组患者的手术时间、术中出血量、术后排气恢复时间、术后住院时间及术后并发症发生情况.结果 (1)观察组患者手术时间、术中出血量、术后排气恢复时间及术后住院时间均明显短于对照组,差异均有统计学意义(P<0.05).(2)观察组患者术后并发症发生率明显低于对照组,差异有统计学意义(χ2=8.963,P=0.024).(3)观察组术后总有效率[95.7%(44/46)]明显高于对照组[78.3%(36/46)],差异有统计学意义(χ2=18.784,P=0.004).结论 老年肝胆管结石患者行胆道镜联合腹腔镜手术,可明显提高临床疗效,减少并发症,值得临床推广应用.