开腹手术与腹腔镜胆囊切除胆道探查术治疗胆囊结石合并胆总管结石的临床效果
王明贵1 ，蔡君惠2
（1.眉县中医院，陕西 宝鸡，722300；2.眉县计划生育指导站，陕西 宝鸡，722300）
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摘要：
目的 对比分析开腹手术与腹腔镜胆囊切除胆道探查术治疗胆囊结石合并胆总管结石的临床效果。方法 选取2014 年 6 月至2017 年6 月我院收治的胆囊结石合并胆总管结石患者100 例，根据治疗方法分为研究组和对照组，各50 例。对照组 给予开腹手术治疗，研究组给予腹腔镜胆囊切除胆道探查术治疗。比较两组患者的临床效果。结果 研究组患者的手术持续 时间、切口长度、住院时间、术中出血量、术后通气时间及恢复进食时间均明显优于对照组（P<0.05）；研究组的并发症总发生 率为6.00%，明显低于对照组的20.00%（P<0.05）。结论 对胆囊结石合并胆总管结石患者采用腹腔镜胆囊切除胆道探查术治 疗具有创伤小、安全可靠、并发症少、术后恢复快等优势，有较高的临床应用价值。
关键词：开腹手术；腹腔镜胆囊切除胆道探查术；胆囊结石合并胆总管结石
中图分类号：R657.4文献标志码：A文章编号：2096-1413(2018)06-0072-02
Clinical effects of laparotomy and laparoscopic cholecystectomy and common bile duct exploration on cholecystolithiasis and choledocholithiasis
WANG Ming-gui 1, CAI Jun-hui 2
(1. Traditional Chinese Medicine Hospital of Mei County, Baoji 722300; 2. Family Planning Guidance Station of Mei County, Baoji 722300, China)
ABSTRACT: Objective To compare and analyze the clinical effects of laparotomy and laparoscopic cholecystectomy and common bile duct exploration on cholecystolithiasis and choledocholithiasis. Methods From June 2014 to June 2017, 100 patients with cholecystolithiasis and choledocholithiasis in our hospital were selected and divided into study group and control group, with 50 cases in each group. The control group was treated with laparotomy, and the study group was treated with laparoscopic cholecystectomy and common bile duct exploration. The clinical effects of the two groups were compared. Results The duration of operation, length of incision, hospital stays, intraoperative blood loss, postoperative ventilation time and time to resume eating in the study group were better than those in the control group (P<0.05). The total incidence of complications in the study group was 6.00% , which was lower than 20.00% of the control group (P<0.05). Conclusion Laparoscopic cholecystectomy and common bile duct exploration in cholecystolithiasis and choledocholithiasis patients has the advantages of less trauma, safe and reliable, less complication and faster recovery after operation, which has high clinical application value.
KEYWORDS: laparotomy; laparoscopic cholecystectomy and common bile duct exploration; cholecystolithiasis and choledocholithiasis
参考文献：
[1] 赵冬雨,成丽娅,沈宏,等.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的临床应用研究[J].中国普外基础与临床杂志,2013,8(7):793-796.
[2] WOODS SE,LEONARD MR,HAYDEN JA,et al.Impaired cholecystokinin-induced gallbladder emptying incriminated in spontaneous "black" pigment gallstone formation in germfree swiss webster mice [J].Gastroenterology,2015,308(4):335-349.
[3] 菅志远,沈先锋,黄林生,等.三种微创方式治疗胆囊结石合并胆总 管结石的临床疗效分析[J].中国普通外科杂志,2015,24(2):275-279.
[4] 何群芝,王兴强,乔铁,等.腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石与传统开腹手术临床对比分析[J].中国内镜杂志,2013,19(9):938-940.
[5] 张鹏,赵景明,张忠涛.开腹胆总管切开取石术与内镜下十二指肠乳头括约肌切开取石术的比较[J].中华肝胆外科杂志,2011,17(9):727-731.
[6] 邵伟怡,宋振顺.胆囊结石合并胆总管结石不同手术方式的选择[J].中国现代普通外科进展,2016,19(11):885-888.
[7] 张乐,白月奎,欧云菘,等.腹腔镜胆囊切除胆道探查术治疗胆囊结石合并胆总管结石的临床观察[J].中国普通外科杂志,2014,23(8):1141-1143.
[8] 刘伟,郑军,赵延春.腹腔镜联合胆道镜微创手术与开腹手术治疗胆囊结石合并胆总管结石的疗效比较[J].现代生物医学进展,2012,12(12):2359-2361.