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双镜微创与开腹手术治疗胆囊结石合并胆总管结石的临床研究

陈明   

  1. 天津医科大学第二医院
  • 收稿日期:2012-04-28 修回日期:2012-06-27 出版日期:2012-10-15 发布日期:2012-10-15
  • 通讯作者: 陈明

Clinical research of double mirror minimally invasive operation and laparotomy in treatment of cholecystolithiasis and choledocholithiasis

Ming CHEN   

  • Received:2012-04-28 Revised:2012-06-27 Published:2012-10-15 Online:2012-10-15
  • Contact: Ming CHEN

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摘要： 【摘 要】 目的 研究对比经十二指肠镜十二指肠乳头切开取石（EST）联合腹腔镜胆囊切除术（LC）与开腹手术治疗胆囊结石合并胆总管结石的临床疗效。方法 收集我院6年间60例胆囊结石合并胆总管结石的病人，分别实施双镜微创手术（30例）及开腹手术（30例），对比实施两种术式病人的疗效。结果 双镜微创手术出血量、住院时间、残余结石率、切口感染等指标均明显优于开腹手术(P <0.05), 医源性胰腺炎发生率(23.3%)高于开腹手术，胆漏发生率(13.3%)低于开腹手术，差异有统计学意义(P<0.05)。结论 双镜微创治疗胆囊结石合并胆总管结石具有创伤小、出血少、住院时间短、无残余结石、术后恢复快等优点。仍有相应的并发症。

关键词: ERCP, EST, 腹腔镜胆囊切除术, 胆囊结石, 胆总管结石

Abstract: Abstract: 【Objective】 To investigate clinical curative effect on endoscopic sphincterotomy ( EST ) combined with laparoscopic cholecystectomy ( LC ) and laparotomy in treatment of cholecystolithiasis and choledocholithiasis.【Method】60 cases with cholecystolithiasis and choledocholithiasis collected were analyzed,compared the effect of double mirror minimally invasive operation ( 30 cases) and laparotomy (30 cases ).【Results】Double mirror minimally invasive operation was significantly better than laparotomy in bleeding,hospitalization time, residual stone rate and infection of incisional wound ( P < 0.05 ), The difference was statistically significant in iatrogenic pancreatitis rate(23.3%)and bile leakage rate(13.3%) .【Conclusion】There are less trauma, less bleeding, shorter hospitalization time, no residual stones, rapid postoperative recovery in double mirror minimally invasive treatment of gallstones and bile duct stones, still some complications.

Key words: ERCP, EST, laparoscopic cholecystectomy, cholecystolithiasis, choledocholithiasis