腹腔镜联合十二指肠镜治疗胆结石合并胆总管结石的临床疗效

目的:探讨腹腔镜联合十二指肠镜治疗胆结石合并胆总管结石的临床疗效。方法:收集我院肝胆科2012年6月到2014年3月住院的胆结石合并胆总管结石60例,按照随机数字表法分为试验组和对照组,各30例,试验组给予腹腔镜联合十二指肠镜治疗,对照组给予传统的开腹胆囊切除以及胆总管探查取石,观察对比两组的临床疗效。结果:试验组手术时间、住院时间、术后恢复时间及术中出血量明显的短于或少于对照组,差异均具有统计学意义(均P0.05),试验组治愈率为96.7%明显的高于对照组的66.7%,差异有统计学意义(P0.05)。两组主要不良反应有:结石残留、感染、十二指肠穿孔、恶性呕吐及伤口疼痛等,试验组不良反应发生率为16.67%明显的低于对照组总的73.33%,差异有统计学意义(P0.05)。结论:腹腔镜联合十二指肠镜治疗胆结石合并胆总管结石较传统的开腹手术治疗的效果好、恢复时间短、手术创伤小,且具有一定的安全性,不良反应发生少,值得临床推广使用。

Clinical Efficacy of Laparoscopic Combined with Duodenoscopy inTreatment of Gallstones and Bile Duct Stones

Objective:To evaluate clinical efficacy of laparoscopic combined with duodenoscopy in treatment of gallstones andbile duct stones.Methods:60 cases of patients with gallstones and bile duct stones from June 2012 to March 201 4 in department of Hepatobiliary Hospital were randomly divided into the experimental group(30 cases) and the control group(30 cases). The experimental groupreceived laparoscopic joint duodenoscopy treatment. The control group were given conventional open cholecystectomy and common bileduct exploration, clinical efficacy of the two groups was observed and compared.Results:The operative time, length of hospital stay,postoperative recovery time and blood loss were significantly shorter or less than those in the control group, the differences were statistically significant (P<0.05), the cure rate of the experimental group was 96.7%, higher than the that of the control group(66.7%), the difference was statistically significant (P<0.05). The main adverse events that occurred in the two groups were residual stones, infection, duodenal perforation, wound pain, vomiting, and vicious. The total incidence of adverse events of experimental group was 1 6.67%, significantly lower than that ofthe control group (73.33%), the difference between the two groups was statistically significant (P<0.05).Conclusion:Laparoscopic combined with duodenoscopy in the treatment of gallstones and bile duct stones presents better clinical efficacy than traditional open surgery, the recovery time is shorter, surgical trauma is less and shows certain safety, less adverse reactions, and is worthy ofclinical application.