腹腔镜下胆总管探查术与内窥镜下十二指肠乳头括约肌切开术治疗胆总管结石的临床效果比较分析(1)
【摘要】 目的：观察分析腹腔镜下胆总管探查术与内窥镜下十二指肠乳头括约肌切开术治疗胆总管结石的临床效果。方法：选择本院2014年6月-2016年2月進行治疗的120例胆总管结石患者作为研究对象，采用随机方法将其分为研究组和对照组，每组各60例。研究组患者采取腹腔镜下胆总管探查术治疗，对照组患者采取内窥镜下十二指肠乳头括约肌切开术治疗，比较分析两组患者的操作成功率、一期手术治愈率、残余结石与病变率、住院时间、围术期间并发症发生情况。结果：治疗后，研究组患者操作成功率为98.3%，对照组患者操作成功率为96.7%，两组比较差异无统计学意义(P>0.05)。研究组患者一期手术治愈率为83.3%，对照组患者一期手术治愈率为48.3%，两组比较差异有统计学意义(P<0.05)。研究组患者术后残余病变主要为残余结石，残余病变率为10.0%，对照组患者术后残余病变主要为肝内外的胆结石与未处理的胆囊病变，残余病变率为46.7%，两组比较差异有统计学意义(P<0.05)。研究组患者手术时间、术中出血量、术后疼痛持续时间、排气时间明显优于对照组，两组比较差异有统计学意义(P<0.05)。研究组患者术后并发症发生率为8.3%，对照组为36.7%，两组比较差异有统计学意义(P<0.05)。研究组患者平均住院时间为(12.3±1.1)d，住院费用为(2.2±0.7)万元，对照组患者平均住院时间为(12.6±1.2)d，住院费用为(2.3±0.8)万元，两组患者住院时间与住院费用比较差异无统计学意义(P>0.05)。结论：胆总管结石患者通过腹腔镜下胆总管探查术和内镜下十二指肠乳头括约肌切开术治疗，具有较高的操作成功率，同时住院时间短等优点，但腹腔镜下胆总管探查术具有并发症发生率低，残余病变率低的优势，故临床上对胆总管结石患者优先选用腹腔镜下胆总管探查术治疗。
【关键词】 腹腔镜； 胆总管探查术； 括约肌切开术； 胆总管结石
【Abstract】 Objective：To observe and analyze the clinical effects of of laparoscopic common bile duct exploration and endoscopic sphincterotomy in the treatment of common bile duct stones.Method：120 patients with common bile duct stones and who accepted treatments in our hospital from June 2014 to February 2016 were selected as the research objects， according to the random method they were divided into two groups，60 patients in each group.The study group was treated with laparoscopic common bile duct exploration，while the control group was treated with endoscopic sphincterotomy.Then，the success rate of operation， the cure rate of the first stage operation， the residual stones，the rate of the disease，hospitalization time and incidence of complications during perioperative period of two groups were comparative analyzed.Result：After treatment，the success rate of study group was 98.3%， while the control group was 96.7%，the difference was no statistically significant(P<0.05).The cure rate in study group was 83.3%，while the control group was 48.3%，the difference was statistically significant(P<0.05).In the study group the residual lesions after operation were mainly residual stones， the rate of residual disease was 10.0%，the control group was 46.7%， the difference was statistically significant(P<0.05).The operation time，bleeding volume，duration of postoperative pain，and exhaust time in the study group were significantly better than those of the control group，the results were statistically significant(P<0.05).The complication rate was 8.3% after operation in the study group while in the control group was 36.7%，the difference was statistically significant(P<0.05). In the study group，the average hospitalization time was (12.3±1.1)d， and the hospitalization cost was (2.2±0.7)×104 yuan，and in the control group，the average hospitalization time was (12.6±1.2)d，the hospitalization cost was (2.3±0.8)×104 yuan，and there was no significant difference in the hospitalization time and the hospitalization cost between the two groups(P>0.05).Conclusion：The laparoscopic common bile duct exploration and endoscopic sphincterotomy in treatment of patients with common bile duct stones，which has higher success rate.At the same time，hospitalization time is short and has other advantages，but the laparoscopic common bile duct exploration has the advantage of low incidence of complications and low rate of residual disease.Therefore，the clinical treatment of patients with common bile duct stones were preferred laparoscopic common bile duct exploration., http://www.100md.com(邱忠伟 邱菊)
【关键词】 腹腔镜； 胆总管探查术； 括约肌切开术； 胆总管结石
【Abstract】 Objective：To observe and analyze the clinical effects of of laparoscopic common bile duct exploration and endoscopic sphincterotomy in the treatment of common bile duct stones.Method：120 patients with common bile duct stones and who accepted treatments in our hospital from June 2014 to February 2016 were selected as the research objects， according to the random method they were divided into two groups，60 patients in each group.The study group was treated with laparoscopic common bile duct exploration，while the control group was treated with endoscopic sphincterotomy.Then，the success rate of operation， the cure rate of the first stage operation， the residual stones，the rate of the disease，hospitalization time and incidence of complications during perioperative period of two groups were comparative analyzed.Result：After treatment，the success rate of study group was 98.3%， while the control group was 96.7%，the difference was no statistically significant(P<0.05).The cure rate in study group was 83.3%，while the control group was 48.3%，the difference was statistically significant(P<0.05).In the study group the residual lesions after operation were mainly residual stones， the rate of residual disease was 10.0%，the control group was 46.7%， the difference was statistically significant(P<0.05).The operation time，bleeding volume，duration of postoperative pain，and exhaust time in the study group were significantly better than those of the control group，the results were statistically significant(P<0.05).The complication rate was 8.3% after operation in the study group while in the control group was 36.7%，the difference was statistically significant(P<0.05). In the study group，the average hospitalization time was (12.3±1.1)d， and the hospitalization cost was (2.2±0.7)×104 yuan，and in the control group，the average hospitalization time was (12.6±1.2)d，the hospitalization cost was (2.3±0.8)×104 yuan，and there was no significant difference in the hospitalization time and the hospitalization cost between the two groups(P>0.05).Conclusion：The laparoscopic common bile duct exploration and endoscopic sphincterotomy in treatment of patients with common bile duct stones，which has higher success rate.At the same time，hospitalization time is short and has other advantages，but the laparoscopic common bile duct exploration has the advantage of low incidence of complications and low rate of residual disease.Therefore，the clinical treatment of patients with common bile duct stones were preferred laparoscopic common bile duct exploration., http://www.100md.com(邱忠伟 邱菊)