腹腔镜与开腹胆总管切开取石的比较.docVIP

精品论文 参考文献 腹腔镜与开腹胆总管切开取石的比较 陈平常 刘剑平（耒阳市中医院 湖南耒阳 421800） 【中图分类号】R657.4 【文献标识码】A 【文章编号】1672-5085 (2010)30-0060-02 【摘要】 目的 探讨腹腔镜胆囊切除、胆总管探查取石术（laparoscopic cholecystectomy and common bile duct exploration LC+LCBDE）治疗胆总管结石的优越性。方法 分析2005年6月至2009年6月耒阳市中医院手术治疗的胆总管结石100例的临床资料，LC+LCBDE术治疗46例，开腹手术治疗54例，比较两组平均手术时间、平均住院日、平均住院费用及并发症。结果 两组平均手术时间、平均住院日有显著差异（Plt;0.01）；开腹手术组切口脂肪液化或切口感染4例，与LC+LCBDE组比较，两组有显著差异（Plt;0.05）；平均住院费用、结石残留两组无差异（Pgt;0.05）；随访1-5年，结石复发两组各2例，无差异（Pgt;0.05）。结论 胆总管结石的治疗，LC+LCBDE优于开腹手术，但胆总管直径lt;1.0cm，不宜行LCBDE术。 【关键词】 胆总管结石 腹腔镜手术 开腹手术 Comparison between laparoscopic common bile duct exploration and open abdomen surgery for common bile duct stone 【Abstract】 Objective To investigate the advantage of laparoscopic cholecystectomy and common bile duct exploration(LC+LCBED) for common bile duct stone . Methods The clinical data of 102 patients treated in Chinese Tradition Medical Hospital of LeiYang from June 2005 to June 2009 were analyzed . Of the 102 patients , 48cases were treated by LC+LCBED and 54cases by open abdomen surgery . The two groups were compared in average operation time , be in hospital days , average cost and complication rate . Results There are statistical difference in the average operation time , be in hospital the average days between two groups(Plt;0.01) . In open abdomen surgery group , fat changed to liquid state or infect in opening was seen 4cases, there are statistical difference compared with LC+LCBDE group(Plt;0.05) . There are no statistical difference in the average cost , stones remain rate between two groups(Pgt;0.05). All the patients were followed up for one to six years. In two groups , the bile duct recurrent stones both were seen in 2cases . There are no statistical difference between two groups(Pgt;0.05). Conclusion To treating of common bile duct stone , LC+LCBDE is better than open abdomen. When the bile duct diameter smaller 1.0cm , LCBDE will be by not put to good use. 【Key words】 Common bile duct stones Laparo