目的：比较腹腔镜下胆囊切除术（LC）加腹腔镜下胆总管切开探查术（LCBD）与传统开腹取石术在老年胆道结石合并感染患者中的疗效，分析LC+LCBD的优势。方法：回顾性分析本院收治的120例老年胆道结石合并胆道感染患者临床资料，按照手术方式分为腹腔镜组（72例）及开腹组（48例），腹腔镜组采用LC+LCBD手术治疗，开腹组采用传统开腹取石术治疗。结果：腹腔镜组手术时间显著长于开腹组（P<0.001）；腹腔镜组患者的术中失血量、术后镇痛药使用例数、术后下地活动时间、术后胃肠功能恢复时间、术后ICU住院天数及术后住院时间均显著低于开腹组（P<0.05）；两组患者的术后出血、术后胆漏及术后结石残留发生率比较差异无统计学意义（P>0.05）；腹腔镜组患者术后感染率显著低于开腹组（P<0.05）。结论：LC+LCBD治疗老年胆道结石合并感染患者具有术中失血量少、术后恢复快、住院时间短及术后感染率低等优势。%Objective:To compare the efficacy of laparoscopic cholecystectomy (LC) combined with common bile duct exploration surgery (LCBD) and traditional open stone surgery for biliary calculi combined with infection in elderly patients and analysis the advantage of LC combined with LCBD.Method:120 biliary calculi combined with infection patients’ clinical date were retrospectively analyzed.They were divided into the laparoscopic group and the laparotomy group.The laparoscopic group was treated with LC combined with LCBD surgery,the laparotomy group was treated with traditional open stone surgery.Result:The operation time of the laparoscopic group was significantly longer than that of the laparotomy group(P<0.001).The intraoperative blood loss,number of postoperative analgesic use,postoperative ambulation time, postoperative gastrointestinal function recovery time,postoperative stay days in ICU and postoperative hospital stays of the laparoscopic group were significantly lower than those of the laparotomy group(P<0.05).The postoperative bleeding rate,postoperative bile leakage rate and the incidence rate of postoperative residual stones in the two groups had no significant difference(P>0.05).The postoperative infection rate of the laparoscopic group was significantly lower than that of the laparotomy group(P<0.05).Conclusion:In the treatment of Biliary calculi combined with infection in elderly patients,compared with the traditional open stone surgery,LC combined with LCBD has the advantages of less blood loss,faster recovery,shorter hospital stays and lower postoperative infection rates.
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