腹腔镜辅助胆道镜保胆取石术135例临床的应用分析.docVIP

腹腔镜辅助胆道镜保胆取石术135例临床的应用分析 　　【摘要】 目的：分析腹腔镜辅助胆道镜保胆取石术的手术方法和适应证。方法：回顾性分析中山大学附属第一医院东院2008年3月-2012年3月135例行腹腔镜辅助胆道镜保胆取石术患者的临床资料，记为腹腔镜组，选取同期开腹手术患者61例为对照，记为开放组，分析比较两组患者术后疗效及并发症等的差异。结果：腹腔镜组135例患者中共成功施行腹腔镜辅助胆道镜保胆取石术112例，中转为开腹取石术23例，无胆漏、无残留结石、无胆道出血及腹腔感染等，全组术后无死亡。腹腔镜组术后出院时间、并发症、伤口不适时间、镇痛泵使用方面均优于开放组，但住院费用也高于开放组，差异均有统计学意义（P0.01）。结论：腹腔镜辅助胆道镜保胆取石术简单、安全、有效，是治疗胆囊结石的一种值得推广的微创治疗方法。 　　【关键词】 腹腔镜辅助； 胆道镜； 保胆取石 　　【Abstract】 Objective：To analyze the operative methods and indications of laparoscopic-choledochoscopy-assisted removal of cholelithotomy.Method：The clinical data of 135 patients undergoing laparoscopic-choledochoscopy-assisted removal of cholelithotomy treatment in the Eastern Hospital of the First Affiliated Hospital， Sun Yat-sen University from March 2008 to March 2012 were retrospectively analyzed as the laparoscopic group，while contemporary 61 patients undergoing open cholecystectomy were selected as the comparison，which were recorded as the open group.The postoperative curative effect and complications of two groups were compared.Result：In the laparoscopic group，it had completed successful laparoscopic-choledochoscopy-assisted removal of cholelithotomy to 112 patients in total 135 patients，and 23 patients changed to open cholecystectomy in the operation.There were no leaked，no residual stones，no bleeding or peritoneal cavity infection，and no patient died.The discharge time，complications，time of wound pain，analgesic required of the laparoscopic group were better than those of the open group，but the hospitalization costs of the laparoscopic group was higher than the open group，the differences were statistically significant（P0.01）.Conclusion：Laparoscopic-choledochoscopy-assisted removal of cholelithotomy is a simple，safe，and effective operative method and is worth popularizing in minimally invasive treatment of cholelithiasis. 　　【Key words】 Laparoscopic-assisted； Choledochoscopy； Cholecystolithotomy 　　First-author’s address：The Second People’s Hospital in Yuancheng District