腹腔镜联合胆道镜保胆取石术同期治疗胆囊结石与胆总管结石的疗效观察

目的：观察腹腔镜联合胆道镜保胆取石术同期治疗胆囊结石与胆总管结石的临床疗效。方法：随机将48例胆囊结石合并胆总管结石患者分为观察组和对照组，观察组采用腹腔镜联合胆道镜保胆取石术，对照组采用传统切开胆囊胆总管取石术。结果：观察组的手术时间（93．7±17．O）min明显小于对照组的（118．7±10．6）min，t=4．37，P=O．049〈0．05；观察组的术中出血量（91．7±27．3）mL明显小于对照组的（142．7±17．O）mL，t=-6．10，P=0．026〈0．05；观察组的肛门排气时间及住院时间明显小于对照组的，P〈0．05；观察组的切口感染率7．％明显小于对照组20．0％，x2=-7．05，P=0．008〈0．05；观察组的结石复发率3．6％明显小于对照组的15．0％，x2=-7．76，P=0．005〈0．05。结论：腹腔镜联合胆道镜保胆取石术同期治疗胆囊结石与胆总管结石的疗效良好，缩短手术时间，减少术中出血量，提高了安全可靠性，有利于患者术后康复。

Clinical Observation of Patients with Cholecystolithiasis and Choledocholithiasis Using Laparoscopy Combined with Choledochoscopy for Preservation of Cholecyst and Removal of Calculus

Objective： To observe the clinical effect of patients with cholecystolithiasis and choledocholithiasis by Laparoscopy combined with choledochoscopy for preservation of cholecyst and removal of calculus. Methods： 84 patients with cholecystolithiasis and choledocholithiasis were randomly divided into observation group and control group. The patients in observation group were performed by laparoscopy combined with eholedochoscopy for preservation of cholecyst and removal of calculus, while the patients in control group were treated by traditional method. Results： The operation time in observation group was （93.7＋ 17.0） min which was obviously less than that of the control group （118.7＋ 10.6） min, t--4.37, P= 0.049〈0.05; the blood loss in observation group was （91.7＋ 27.3） ml which was obviously less than that of the control group （142.7＋ 17.0） mL, t=-6.10, P=0. 026〈0.05; Anal exhaust time and the length of hospital stay in observation group was obviously less than those of the control group, P〈0.05; Incision infection rate was 7.% in observation group which was obviously less than that of the control group 20.0%, x2=-7.05, P=0.008〈0.05; Recurrence rate was 3.6% in observation group which was obviously less than that of the control groupl5. 0%, x2=7.76, P=0.005〈0.05. Conclusion＂ The clinical curative effect was obvious of patients with cholecystolithiasis and choledoc- holithiasis by Laparoscopy combined with choledochoscopy for preservation of cholecyst and removal of calculus; the method could shorten the operation time, reduce the blood loss, improve the reliability so that it is helpful to patients for postoperative rehabilitation.