腹腔镜联合胆道镜保胆取石术在治疗单发与多发结石的对比分析

摘要

Objective To explore clinical effect combined laparoscopic and choledochoscopic in treatment of single and multiple cholecystolithiasis.MethodsThe data from 68 patients with gall-preserving lithotomy who were treated by combined laparoscopic and choledochoscopic for single and multiple cholecystolithiasis were retrospectively analysed and follow-up.ResultsIn 68 patients, combined smoothly had been successfully treated by laparoscopic and cholangioscopic cholecystolithotomy operation for treatment of single and multiple gallbladder stones . the average operation time of single stone was (50.4 ± 10.6) min, the average hospital stay was (6 ± 1.5) d, the average operation of multiple stones time was (70.4 ± 20.5) min, the average hospital stay was (7 ± 1) d, Comparative two kinds of operation time, P<0.05, however,hospital stay, P>0.05;there were no fever, bile leakage, biliary tract bleeding, abdominal effusion, peritonitis and incision infection and other complications in two groups of postoperation. Follow-up of 6-36 months, there were 3 cases with gallbladder wall thickening with sediment samples of gallbladder stones in multiple gallbladder stones group, 1 cases of gallbladder lesser stones. Group of single gallstone showed no recurrence of calculi. no obvious discomfort, gallbladder function was normal.[Conclusions] Combined laparoscopic and cholangioscopic cholecystolithotomy for patients of single gallballer stone may have better clinical effect than patients of multiple stones.%　　目的探讨腹腔镜胆道镜联合保胆取石术在治疗单发与多发结石的对比及临床效果。方法对2010年3月至2012年9月我院行腹腔镜胆道镜联合保胆取石术随机抽取68例临床资料进行回顾性分析及随访。结果68例患者行腹腔镜胆道镜联合保胆取石手术顺利，单发结石平均手术时间(50．4±10.6)min，平均住院时间(6.0±1.5)d，多发结石平均手术时间(70．4±20.5)min，平均住院时间(7.0±1.0)d，两种手术时间P ＜0.05，住院时间P ＞0.05；两组均无术后发热、胆漏、胆道出血、腹腔积液，腹膜炎及切口感染等并发症。随访6-36个月，多发胆囊结石病例组3例有胆囊内泥沙样结石合并胆囊壁增厚，1例胆囊内多发小结石。单纯胆囊结石组未见结石复发。无明显自觉不适，胆囊收缩功能良好。结论腹腔镜胆道镜联合保胆取石术在治疗单发胆囊结石方面可能更具有临床效果。