[1]曾志华.腹腔镜辅助下胆总管探查术及胆囊切除术治疗胆囊结石合并胆总管结石的效果[J].医学信息,2023,36(20):141-144.[doi:10.3969/j.issn.1006-1959.2023.20.028]
　ZENG Zhi-hua.Effect of Laparoscopic Common Bile Duct Exploration and Laparoscopic Cholecystectomy in the Treatment of Cholecystolithiasis Complicated with Calculus of Common Bile Duct[J].Journal of Medical Information,2023,36(20):141-144.[doi:10.3969/j.issn.1006-1959.2023.20.028]
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腹腔镜辅助下胆总管探查术及胆囊切除术治疗胆囊结石合并胆总管结石的效果()

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年20期
页码:
141-144
栏目:
论著
出版日期:
2023-10-15

文章信息/Info

Title:
Effect of Laparoscopic Common Bile Duct Exploration and Laparoscopic Cholecystectomy in the Treatment of Cholecystolithiasis Complicated with Calculus of Common Bile Duct
文章编号:
1006-1959（2023）20-0141-04
作者:
曾志华
（崇仁县人民医院普通外科-神经外科，江西 崇仁 344299）
Author(s):
ZENG Zhi-hua
(General Surgery-Neurosurgery Department of Chongren County People’s Hospital,Chongren 344299,Jiangxi,China)
关键词:
胆囊结石; 胆总管结石; 腹腔镜辅助下胆总管探查术; 胆囊切除术; 结石清除率
Keywords:
Cholecystolithiasis; Calculus of common bile duct; Laparoscopic assisted common bile duct exploration; Cholecystectomy; Stone clearance rate
分类号:
R575
DOI:
10.3969/j.issn.1006-1959.2023.20.028
文献标志码:
A
摘要:
目的 研究腹腔镜辅助下胆总管探查术（LCBDE）及胆囊切除术（LC）治疗胆囊结石合并胆总管结石（CDS）的临床疗效。方法 选取2019年8月-2022年8月崇仁县人民医院收治的72例胆囊结石合并CDS患者，按照随机数字表法分为对照组（36例）与观察组（36例），对照组应用传统开腹手术治疗，观察组则采用LCBDE联合LC治疗，比较两组结石清除率、围术期指标（手术时间、术中出血量、术后排气时间、术后置管时间、住院时间）、术后并发症、胃肠道生活质量指数（GIQLI）、预后情况（结石复发率、胆管积气发生率、胆道炎发生率）。结果 观察组结石清除率为94.44%，与对照组的97.22%比较，差异无统计学意义（P＞0.05）；观察组手术时间、术后排气时间、术后置管时间、住院时间短于对照组，且术中出血量少于对照组（P＜0.05）；观察组术后并发症发生率小于对照组（P＜0.05）。观察组术后第15、30天GIQLI评分高于对照组（P＜0.05）；观察组与对照组结石复发率比较，差异无统计学意义（P＞0.05），而观察组胆管积气发生率、胆管炎发生率均小于对照组（P＜0.05）。结论 LCBDE联合LC治疗胆囊结石合并CDS效果确切，其结石清除率高、手术时间短、出血少、恢复快，且术后并发症少，胃肠道恢复佳，具有良好的预后表现。
Abstract:
Objective To study the clinical efficacy of laparoscopic common bile duct exploration (LCBDE) and cholecystectomy (LC) in the treatment of cholecystolithiasis with calculus of common bile duct (CDS).Methods From August 2019 to August 2022, 72 patients with cholecystolithiasis and CDS admitted to Chongren County People’s Hospital were selected and divided into control group (36 patients) and observation group (36 patients) according to the random number table method. The control group was treated with traditional laparotomy, while the observation group was treated with LCBDE combined with LC. The stone clearance rate, perioperative indicators (operation time, intraoperative blood loss, postoperative exhaust time, postoperative catheterization time, hospitalization time), postoperative complications, gastrointestinal quality of life index (GIQLI), prognosis (stone recurrence rate, bile duct gas incidence, cholangitis incidence) were compared between the two groups.Results The stone clearance rate of the observation group was 94.44%, which was compared with 97.22% of the control group, the difference was not statistically significant (P>0.05). The operation time, postoperative exhaust time, postoperative catheterization time and hospitalization time of the observation group were shorter than those of the control group, and the intraoperative blood loss was less than that of the control group (P<0.05). The incidence of postoperative complications in the observation group was lower than that in the control group (P<0.05). The GIQLI score of the observation group was higher than that of the control group on the 15th and 30th day after operation (P<0.05). There was no significant difference in the recurrence rate of stones between the observation group and the control group (P>0.05), while the incidence of bile duct pneumatosis and cholangitis in the observation group were lower than those in the control group (P<0.05).Conclusion LCBDE combined with LC is effective in the treatment of cholecystolithiasis and CDS, with high stone clearance rate, short operation time, less bleeding, fast recovery, fewer postoperative complications, good gastrointestinal recovery, and good prognosis.

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更新日期/Last Update: 1900-01-01