【摘要】 目的探讨两种腹腔镜术式治疗胆囊结石合并胆总管结石的手术疗效.方法回顾性分析2006年11月至2012年11月采用腹腔镜微创治疗胆囊结石合并胆总管结石98例患者的临床资料,分为腹腔镜胆道探查T管引流组52例(A组),腹腔镜经胆囊管胆道探查组46例(B组),比较2组间患者的手术时间、手术出血量、手术并发症、术后住院天数、住院费用等差异.结果 A组手术时间、手术出血量、术后腹腔引流时间、术后住院日及住院费用显著长于或高于B组(P<0.05);A组15.4(8/52)和B组13(6/46)手术并发症比较差异无统计学意义(P>0.05).结论在严格掌握适应证的前提下,经胆囊管途径腹腔镜胆道探查术与腹腔镜胆道探查T管引流术相比微创优势明显,安全、可靠,患者术后恢复快,是治疗胆囊结石合并胆总管结石病人优选方法,而传统的胆管切开T管引流是必要的补充方式.更多还原

【Abstract】 Objective To investigate surgical effects of two kinds of laparoscopic surgical treatment on cholecystolithiasis and choledocholithiasis.Methods The clinic data of 98 patients with cholecystolithiasis and choledocholithiasis surgically treated with minimally invasive laparoscopy in the past six years were analyzed retrospectively.The patients were divided into two groups.Group A(52 patients) was treated with laparoscopic common bile duct exploration with T-tube drainage and group B(46 patients)was treated with laparoscopic common bile duct exploration via cystic duct.The operation time,blood loss,surgical complications,postoperative hospital stay and hospital cost were compared between the two groups.Results The operation time,blood loss,postoperative peritoneal cavity drainage time,hospital stay and hospital cost in group A were significantly longer or higher than those in group B(P < 0.05).There was no significant difference in surgical complications between the two groups,with 15.4% in Group A and 13.0% in Group B(P > 0.05).Conclusion Under the strict control of indications,laparoscopic common bile duct exploration surgery via cystic duct pathway was superior to laparoscopic common bile duct exploration with T-tube drainage in terms of its minimal invasion,safety,reliability,quick postoperative recovery.It is a preferred method to treat patients with cholecystolithiasis and choledocholithiasis,and the traditional choledochotomy with T-tube drainage is a necessary complement way.更多还原