引用本文:周宗喜,廖 波,李永周.两种不同方法治疗胆囊结石并胆总管结石的临床疗效比较[J].中国临床新医学,2018,11(10):1020-1024.
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两种不同方法治疗胆囊结石并胆总管结石的临床疗效比较
周宗喜,廖 波,李永周
546899 广西,贺州市昭平县人民医院外一科
摘要:
[摘要] 目的 比较腹腔镜下胆囊切除术+胆总管切开取石术和开腹胆囊切除术+胆总管切开取石术治疗胆囊结石并胆总管结石的临床疗效。方法 将52例胆囊结石并胆总管结石患者按随机数字表法分为腹腔镜组和开腹组,各26例。腹腔镜组(26例)采用腹腔镜下胆囊切除术+胆总管切开取石术+术中胆道镜探查+T管引流术治疗;开腹组(26例)采用开腹胆囊切除术+胆总管切开取石术+术中胆道镜探查+T管引流术治疗,对比两组治疗效果。结果 腹腔镜组手术时间长于开腹组,术后疼痛VAS评分、术后止痛药使用率、术后炎性因子[C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平及术后肛门排气时间、术后住院时间等均低于或短于开腹组,差异均有统计学意义(P<0.05)。结论 腹腔镜下胆囊切除术+胆总管切开取石术创伤较小、应激较轻、术后恢复较快。
关键词:  胆囊结石  胆总管结石  腹腔镜  开腹
DOI:10.3969/j.issn.1674-3806.2018.10.18
分类号:
基金项目:
Comparison of the clinical effects between two different surgical treatments on gallbladder stones complicated with common bile duct stones
ZHOU Zong-xi, LIAO Bo, LI Yong-Zhou
The First Department of Surgery, the People′s Hospital of Zhaoping County, Guangxi 546899, China
Abstract:
[Abstract] Objective To compare the clinical effects on gallbladder stones complicated with common bile duct stones between laparoscopic cholecystectomy + choledocholithotomy and open cholecystectomy + choledocholithotomy. Methods Fifty-two patients with gallbladder stones complicated with common bile duct stones were divided into the laparoscopic group(n=26) and the open group(n=26). The laparoscopic group received cholecystectomy + choledocholithotomy + choledochoscope + T-tube drainage by laparoscopy and the open group was performed open cholecystectomy + choledocholithotomy + choledochoscope + T-tube drainage. The therapeutic effect was compared between the two groups. Results The operative time was significantly longer, and the postoperative pain score(VAS), the rate of using postoperative painkillers, the levels of postoperative inflammatory factors(CRP, IL-6 and TNF-α), the postoperative gastrointestinal motility recovery and the postoperative hospital stay were significantly less in the laparoscopic group than those in the open group(P<0.05). Conclusion Compared with open cholecystectomy+choledocholithotomy, laparoscopic cholecystectomy+choledocholithotomy has less surgery trauma, less inflammatory stress response and faster postoperative recovery in the treatment of gallbladder stones complicated with common bile duct stones.
Key words:  Gallbladder stones  Common bile duct stones  Laparoscopic surgery  Open surgery