腹腔镜联合胆道镜在肝内外胆道结石治疗中的应用.pdf

《腹腔镜联合胆道镜在肝内外胆道结石治疗中的应用.pdf》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、齐齐哈尔医学院学报2014年第35卷第5期JournalofOiqihnrUniversityofMedicine，2014，Vo1．35，No．5·639·．论著．腹腔镜联合胆道镜在肝内外胆道结石治疗中的应用许沈南李晓辉卢旭生张伟亮黄丽君李佳杰【摘要】目的探讨对肝内外胆道结石患者采用腹腔镜联合胆道镜治疗的效果及安全性。方法选择2010年5月至2013年5月我院收治的80例肝内外胆道结石患者作为临床观察对象。按照患者的意愿分为治疗组(4O例)与对照组(40例)。治疗组给予腹腔镜与胆道镜联合治疗，对照

2、组给予常规的开腹手术治疗。主要观察两组患者手术时间、手术出血量、术后下床活动时间、术后并发症率及住院天数等治疗指标。结果治疗组在手术时间、术后下床活动时间及住院天数方面，用时均显著短于对照组(P<0．O5)；治疗组手术出血量也比对照组少，两组比较差异具有统计学意义(P<0．05)；治疗组术后出现胆道出血2例，胆源性胰腺炎1例，感染1例，总并发症率为10％，对照组出现胆漏2例，胆道出血5例，胆源性胰腺炎2例，感染3例，总并发症率是30％，两组并发症率比较差异显著(P<0．05)。结论采用腹腔镜联合胆道

3、镜实施肝内外胆道结石手术，具有比开腹手术创伤小、术中出血量少、术后并发症少等优势，安全有效，疗效确切，此法值得临床推广应用。【关键词】腹腔镜；胆道镜；肝内外胆管结石；效果ApplicationoflaparoscopecombinedwithcholedochoscopeinthetreatmentofbiliarycaiculiXUShen—nan，eta1．Departmentofsurgeryinpeople'sHospital，Puning，Guangdong，515300，China【Ab

4、stract】ObjectiveToinvestigatetheapplicationefficacyoflaparoscopecombinedwithcholedochoscopeinthetreatmentofinternal／externalbiliarycalculiandit'ssafety．MethodsTotally80casesofpatientssuferedfrominternal／extemalbiliarycalculiwereincludedinthisstudy，andt

5、heyweredividedintotreatmentgroup(n=40)andcontrolgroup(n=40)accordingtotheirownwil1．Patientsintreatmentgroupreceivedtherapyunderlaparoscopeandcholedochoscope，whilepatientsincontrolgroupreceivedconventionalsurgicaltherapy．Recordtheoperationtime，amountofb

6、leeding，postoperativeambulationtime，postoperativecomplicationrateandhospitalizetime．ResultsOperativetime，postoperativeambulationtimeandhospitalizetimeofthetreatmentgroupweresignificantlyshorterthanthecontrolgroup，andtheamountofbleedingoftreatmentgroupw

7、aslessthanthecontrolgroup(P<0．05)．Thetotalcomplicationrateintreatmentgroupwas10％(including2casesofbiliarytractbleeding．onecaseofbiliarypancreatitisandonecaseofinfection)，andthetotalcomplicationrateincontrolgroupwas30％(including5casesofbiliarytractbleed

8、ing．2caseofbiliarypancreatitisand3caseofinfection)，complicationratebetweenthetwogroupssignificantlydiferent(P<0．05)．ConclusionsLaparoscopecombinedwithcholedochoscopewasefectiveandsafeinthetreatmentofbiliarycalculiforithadtheadvantagessu