腹腔镜胆总管切开纤维胆管镜取石T管引流术在治疗肝胆管结石中的应用效果
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摘要
目的评价临床对肝胆管结石患者应用腹腔镜总胆管切开纤维胆管镜取石T管引流术治疗的临床现实意义。方法随机抽选于2016年6月至2018年6月我院收治的20例肝胆管结石患者,根据入院看诊顺序分为两组。研究组(n=10)应用腹腔镜总胆管切开纤维胆管镜取石T管引流术,对照组(n=10)应用传统开腹术。评价及比较两组的手术有效性、围手术期临床指标、手术安全性。结果 (1)两组的手术有效性比较:研究组的手术有效性高于对照组,两组对比具有统计学意义(P<0.05);(2)两组的围手术期临床指标对比:两组的手术操作时长比较差异不明显(P>0.05);研究组的出血量、胃肠道蠕动时间、早期活动时间均少于对照组,两组患者结果对比具有统计学意义(P<0.05);(3)两组的手术安全性对比:研究组的手术安全性高于对照组,结果对比具有统计学意义(P<0.05)。结论临床对肝胆管结石患者应用腹腔镜总胆管切开纤维胆管镜取石T管引流术治疗,较传统开腹术的手术优势更大,可提高手术有效性与安全性,促进病情康复。
Objective To evaluate the clinical significance of laparoscopic choledochotomy with fiberoptic cholangioscopy and T-tube drainage in the treatment of hepatolithiasis. Methods Twenty patients with hepatolithiasis admitted to our hospital from June 2016 to June 2018 were randomLy selected and divided into two groups according to the order of admission. The study group(n=10) was treated with laparoscopic choledochotomy and choledochoscopic lithotripsy and T-tube drainage, while the control group(n=10) was treated with traditional laparotomy. To evaluate and compare the operative effectiveness, perioperative clinical indicators and surgical safety of the two groups. Results(1) The comparison of operative effectiveness between the two groups: the operative effectiveness of the study group was higher than that of the control group, and the results of the two groups had statistical significance(P<0.05).(2)Comparison of perioperative clinical indicators between the two groups: there was no significant difference in the operation time between the two groups(P>0.05); the amount of bleeding, gastrointestinal peristalsis time and early activity time of the study group were less than those of the control group, and the results of the two groups had statistical significance(P< 0.05).(3) Comparison of surgical safety between the two groups: the safety of the study group was higher than that of the control group, and the test results were statistically significant(P<0.05). Conclusion Laparoscopic choledocholithotomy with fiberoptic cholangioscopy and T-tube drainage has more advantages than traditional laparotomy in the treatment of hepatolithiasis. It can improve the effectiveness and safety of the operation and promote the recovery of the disease.
Objective To evaluate the clinical significance of laparoscopic choledochotomy with fiberoptic cholangioscopy and T-tube drainage in the treatment of hepatolithiasis. Methods Twenty patients with hepatolithiasis admitted to our hospital from June 2016 to June 2018 were randomLy selected and divided into two groups according to the order of admission. The study group(n=10) was treated with laparoscopic choledochotomy and choledochoscopic lithotripsy and T-tube drainage, while the control group(n=10) was treated with traditional laparotomy. To evaluate and compare the operative effectiveness, perioperative clinical indicators and surgical safety of the two groups. Results(1) The comparison of operative effectiveness between the two groups: the operative effectiveness of the study group was higher than that of the control group, and the results of the two groups had statistical significance(P<0.05).(2)Comparison of perioperative clinical indicators between the two groups: there was no significant difference in the operation time between the two groups(P>0.05); the amount of bleeding, gastrointestinal peristalsis time and early activity time of the study group were less than those of the control group, and the results of the two groups had statistical significance(P< 0.05).(3) Comparison of surgical safety between the two groups: the safety of the study group was higher than that of the control group, and the test results were statistically significant(P<0.05). Conclusion Laparoscopic choledocholithotomy with fiberoptic cholangioscopy and T-tube drainage has more advantages than traditional laparotomy in the treatment of hepatolithiasis. It can improve the effectiveness and safety of the operation and promote the recovery of the disease.
引文
[1]李乐其,勾守建,杜金平.腹腔镜胆总管切开纤维胆管镜取石T管引流术在治疗肝胆管结石中的效果[J].临床研究,2017,25(3):142-143.
[2]沙聪,杨峻峰,胡伟.腹腔镜胆总管切开取石术后行T管引流与一期缝合治疗肝外胆管结石的疗效分析[J].黑龙江医学,2016,40(11):1002-1003.
[3]何耀鹏,焦文萍,邓睿,等.腹腔镜联合胆道镜胆总管切开取石一期缝合术治疗肝外胆管结石的临床效果[J].广西医科大学学报,2017,34(10):1502-1504.
[4]韩明明,张宝,杨壮杰,等.继发性肝外胆管结石患者腹腔镜下经胆囊管胆总管探查取石术的疗效[J].实用医学杂志,2016,32(12):1991-1993.
[5]高宇.胆道镜在取石配合腹腔镜肝切除术在区域型肝胆管结石病中的可行性分析[J].世界最新医学信息文摘,2016,16(55):53-53.
[6]罗晓峰,王振龙,何涛,等.腹腔镜经左肝断面胆管行硬质胆道镜探查胆总管取石的研究[J].岭南现代临床外科,2016,16(2):145-148.
[7]陈洋,司亚卿,王钊,等.完全腹腔镜下左肝蒂阻断行左半肝切除术治疗肝内外胆管结石[J].中国普通外科杂志,2016,25(8):1093-1099.
[8]刘新,刘建郭,付军,等.肝外胆管结石腹腔镜联合胆道镜切开取石一期缝合的临床疗效研究[J].白求恩医学杂志,2017,15(1):11-13.
[9]庞克斌,张小弟.三种不同方式腹腔镜胆道探查术治疗肝外胆管结石的疗效比较分析[J].临床医学研究与实践,2017,2(21):68-69.
[10]李汉军,曹庭加,梅洪亮,等.腹腔镜联合胆道镜治疗有上腹部手术史的肝外胆管结石63例分析[J].腹部外科,2017,30(5):353-356.
[11]夏韬.腹腔镜联合十二指肠镜同期治疗胆囊结石并肝外型肝胆管结石[J].中医临床研究,2017,9(6):99-100.
[12]张新龙,陈智全,刘学军.腹腔镜经胆囊管胆道探查术治疗肝外胆管结石的疗效分析[J].肝胆胰外科杂志,2017,29(6):444-448.
[13]段兰芳.腹腔镜胆总管切开探查取石T管引流术13例护理体会[J].基层医学论坛,2017,21(24):3185-3186.
[14]廖华.肝胆管结石应用腹腔镜联合胆道镜手段治疗的疗效研究[J].临床医学工程,2016,23(10):1288-1289.
[15]Kenny R,Richardson J,McGlone ER,et al.Laparoscopic common bile duct exploration versus pre or postoperative ERCP for common bile duct stones in patients undergoing cholecystectomy:is there any difference[J].Int JSurg,2014,12(9):989-993.
[16]Ding G,Cai W,Qin M.Single-stage vs.two-stage management for concomitant gallstones and common bile duct stones:a prospec tive randomized trial with long-term follow-up[J].J Gastrointest Surg,2014,18(5):947-951.
[17]檀占海,朱光辉,陈建荣.腹腔镜胆囊切除术联合胆总管切开取石T管引流术治疗胆囊并胆总管结石的效果分析[J].临床肝胆病杂志,2017,33(5):883-887.
[2]沙聪,杨峻峰,胡伟.腹腔镜胆总管切开取石术后行T管引流与一期缝合治疗肝外胆管结石的疗效分析[J].黑龙江医学,2016,40(11):1002-1003.
[3]何耀鹏,焦文萍,邓睿,等.腹腔镜联合胆道镜胆总管切开取石一期缝合术治疗肝外胆管结石的临床效果[J].广西医科大学学报,2017,34(10):1502-1504.
[4]韩明明,张宝,杨壮杰,等.继发性肝外胆管结石患者腹腔镜下经胆囊管胆总管探查取石术的疗效[J].实用医学杂志,2016,32(12):1991-1993.
[5]高宇.胆道镜在取石配合腹腔镜肝切除术在区域型肝胆管结石病中的可行性分析[J].世界最新医学信息文摘,2016,16(55):53-53.
[6]罗晓峰,王振龙,何涛,等.腹腔镜经左肝断面胆管行硬质胆道镜探查胆总管取石的研究[J].岭南现代临床外科,2016,16(2):145-148.
[7]陈洋,司亚卿,王钊,等.完全腹腔镜下左肝蒂阻断行左半肝切除术治疗肝内外胆管结石[J].中国普通外科杂志,2016,25(8):1093-1099.
[8]刘新,刘建郭,付军,等.肝外胆管结石腹腔镜联合胆道镜切开取石一期缝合的临床疗效研究[J].白求恩医学杂志,2017,15(1):11-13.
[9]庞克斌,张小弟.三种不同方式腹腔镜胆道探查术治疗肝外胆管结石的疗效比较分析[J].临床医学研究与实践,2017,2(21):68-69.
[10]李汉军,曹庭加,梅洪亮,等.腹腔镜联合胆道镜治疗有上腹部手术史的肝外胆管结石63例分析[J].腹部外科,2017,30(5):353-356.
[11]夏韬.腹腔镜联合十二指肠镜同期治疗胆囊结石并肝外型肝胆管结石[J].中医临床研究,2017,9(6):99-100.
[12]张新龙,陈智全,刘学军.腹腔镜经胆囊管胆道探查术治疗肝外胆管结石的疗效分析[J].肝胆胰外科杂志,2017,29(6):444-448.
[13]段兰芳.腹腔镜胆总管切开探查取石T管引流术13例护理体会[J].基层医学论坛,2017,21(24):3185-3186.
[14]廖华.肝胆管结石应用腹腔镜联合胆道镜手段治疗的疗效研究[J].临床医学工程,2016,23(10):1288-1289.
[15]Kenny R,Richardson J,McGlone ER,et al.Laparoscopic common bile duct exploration versus pre or postoperative ERCP for common bile duct stones in patients undergoing cholecystectomy:is there any difference[J].Int JSurg,2014,12(9):989-993.
[16]Ding G,Cai W,Qin M.Single-stage vs.two-stage management for concomitant gallstones and common bile duct stones:a prospec tive randomized trial with long-term follow-up[J].J Gastrointest Surg,2014,18(5):947-951.
[17]檀占海,朱光辉,陈建荣.腹腔镜胆囊切除术联合胆总管切开取石T管引流术治疗胆囊并胆总管结石的效果分析[J].临床肝胆病杂志,2017,33(5):883-887.