【摘要】 目的 探讨腹腔镜胆总管探查术(LCBDE)在诊疗老年复发性胆总管结石中的疗效与安全性。方法 选取2019年10月～2022年5月期间本院收治的70例老年复发性胆总管结石患者为研究对象，按照手术方法分为LCBDE组(n=35)和开腹胆总管探查术(OCBDE)组(n=35)。比较两组手术成功率、手术相关指标、肝功能指标以及近远期并发症发生情况。结果 两组术后残余结石率、术中出血量、胃肠道功能恢复时间比较，差异无统计学意义(P>0.05)。LCBDE组复发率明显低于OCBDE组，手术时间、住院时间明显短于OCBDE组，差异有统计学意义(P<0.05)。两组术后3d的肝功能指标水平比较，差异无统计学意义(P>0.05)。LCBDE组术后发热和近期并发症总发生率明显低于OCBDE组，差异有统计学意义(P<0.05)。结论 LCBDE治疗老年复发性胆总管结石安全可行，有助于缩短手术时间和住院时间，术后近期并发症发生率更少。更多还原

【Abstract】 Objective To investigate the efficacy and safety of laparoscopic common bile duct exploration( LCBDE) in the diagnosis and treatment of recurrent common bile duct stones in the elderly. Methods 70 elderly patients with recurrent common bile duct stones admitted to our hospital from October 2019 to May 2022 were selected as the research objects. According to the surgical methods, they were divided into LCBDE group( n=35) and endoscopic sphincterotomy( OCBDE) group( n=35). The success rate of operation, operation related indexes, liver function indexes and short-term and long-term complications were compared between the two group.Results There was no significant difference in postoperative residual stone rate, intraoperative blood loss and gastrointestinal function recovery time between the two groups( P > 0.05). The recurrence rate of LCBDE group was significantly lower than that of OCBDE group, and the operation time and hospitalization time were significantly shorter than those of OCBDE group(P<0.05). The total incidence of postoperative fever and recent complications in LCBDE group was significantly lower than that in OCBDE group(P<0.05).Conclusion LCBDE is safe and feasible in the treatment of recurrent common bile duct stones in the elderly, which can shorten the operation time and hospitalization time, and reduce the incidence of postoperative complications.更多还原