腹腔镜联合胆道镜治疗胆囊息肉并发胆囊结石的临床效果及预后作用探讨
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摘要
目的探究腹腔镜联合胆道镜治疗胆囊息肉并发胆囊结石的临床效果及预后作用。方法方便选取该院2015年12月—2017年12月期间收治的80例胆囊息肉并发胆囊结石手术患者作为观察对象,对其临床资料进行回顾性分析,根据患者不同的治疗方案进行分组,分别设为对照组(传统开腹胆囊切除术治疗)和观察组(腹腔镜联合胆道镜治疗)各40例,观察分析两组患者手术情况、术后并发症发生率及远期随访复发情况。结果采取腹腔镜联合胆道镜治疗的观察组术中出血量明显少于对照组,手术时间、下床活动时间、术后肛门排气时间及住院时间均明显短于对照组,差异有统计学意义(P<0.05);观察组与对照组术后并发症发生率分别为5.00%和22.50%,差异有统计学意义(χ2=5.16;P=0.02);观察组与对照组患者远期疾病复发率分别为2.50%和5.00%,差异无统计学意义(χ2=0.35;P=0.56)。结论腹腔镜联合胆道镜治疗胆囊息肉并发胆囊结石的临床效果确切,患者术中出血量少,手术时间短,康复快,术后并发症发生率少,临床效果明显优于传统开腹胆囊切除术。
Objective To explore the clinical effect and prognosis of laparoscopy combined with choledochoscopy in the treatment of gallbladder polyps complicated with gallstones. Methods Convenient select 80 patients with gallbladder polyp complicated with gallstone were treated in our hospital from December 2015 to December 2017. Their clinical data were retrospectively analyzed. They were divided into control group(traditional open cholecystectomy) and observation group(abdominal cavity) according to different treatment schemes. Forty patients were treated by choledochoscopy combined with choledochoscopy. The operation condition, the incidence of complications and the recurrence of long-term follow-up were observed and analyzed. Results The amount of intraoperative blood loss in the observation group treated by laparoscopy combined with choledochoscopy was significantly less than that in the control group, and the operation time, ambulation time, postoperative anal exhaust time and hospitalization time were significantly shorter than those in the control group, with statistically significant differences(P<0.05). The incidence of postoperative complications in the observation group and the control group was 5.00% and 22.50% respectively, the difference was statistically significant(χ~2=5.16; P=0.02). The recurrence rate of long-term diseases in the observation group and the control group was 2.50 % and 5.00 % respectively, with no statistical difference(χ~2=0.35; P=0.56). Conclusion Laparoscopy combined with choledochoscope has definite clinical effect in the treatment of gallbladder polyps complicated with cholecystolithiasis. The operation time is short, the recovery is fast, and the incidence of complications is low. The clinical effect is obviously better than that of traditional open cholecystectomy.
Objective To explore the clinical effect and prognosis of laparoscopy combined with choledochoscopy in the treatment of gallbladder polyps complicated with gallstones. Methods Convenient select 80 patients with gallbladder polyp complicated with gallstone were treated in our hospital from December 2015 to December 2017. Their clinical data were retrospectively analyzed. They were divided into control group(traditional open cholecystectomy) and observation group(abdominal cavity) according to different treatment schemes. Forty patients were treated by choledochoscopy combined with choledochoscopy. The operation condition, the incidence of complications and the recurrence of long-term follow-up were observed and analyzed. Results The amount of intraoperative blood loss in the observation group treated by laparoscopy combined with choledochoscopy was significantly less than that in the control group, and the operation time, ambulation time, postoperative anal exhaust time and hospitalization time were significantly shorter than those in the control group, with statistically significant differences(P<0.05). The incidence of postoperative complications in the observation group and the control group was 5.00% and 22.50% respectively, the difference was statistically significant(χ~2=5.16; P=0.02). The recurrence rate of long-term diseases in the observation group and the control group was 2.50 % and 5.00 % respectively, with no statistical difference(χ~2=0.35; P=0.56). Conclusion Laparoscopy combined with choledochoscope has definite clinical effect in the treatment of gallbladder polyps complicated with cholecystolithiasis. The operation time is short, the recovery is fast, and the incidence of complications is low. The clinical effect is obviously better than that of traditional open cholecystectomy.
引文
[1]还勇为,周大勇,孙波,等.腹腔镜联合胆道镜治疗胆囊息肉并发胆囊结石的临床观察[J].中华普外科手术学杂志:电子版, 2015, 9(5):27-29.
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[6]华龙.腹腔镜联合胆道镜治疗胆囊息肉并发胆囊结石的疗效及预后效果观察[J].中国现代药物应用, 2016,10(19):85-87.
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[8]马灿业,李宝金,廖坚松,等.腹腔镜联合胆道镜治疗胆囊息肉样病变的术后康复情况[J].实用医学杂志, 2016, 32(12):1979-1982.
[9]马建华.老年胆囊息肉患者不同手术治疗对于机体免疫功能的影响[J].中国医药导刊, 2016, 18(6):547-549.
[10]伍贤能,蒋辉,朱叶辉,等.腹腔镜联合胆道镜治疗胆囊息肉并胆囊结石的价值和可行性研究[J].当代医学, 2016,22(8):90-91.
[2]王维,李海林,韩光宁,等.腹腔镜联合胆道镜治疗胆囊息肉合并胆囊结石的临床效果[J].现代生物医学进展, 2015,15(19):3698-3700.
[3]单志龙.探讨腹腔镜联合胆道镜在胆囊息肉合并胆囊结石保胆术治疗中的效果[J].中外医学研究,2016,14(10):29-30.
[4]吴世乐,郭亚民,吴新民,等.微创内镜保胆取息肉术治疗胆囊息肉的临床疗效、并发症及远期预后[J].临床和实验医学杂志, 2016, 15(23):2359-2362.
[5]熊文欣.腹腔镜联合胆道镜微创保胆治疗胆囊结石及胆囊息肉的疗效观察[J].临床医药文献电子杂志, 2016, 3(5):857.
[6]华龙.腹腔镜联合胆道镜治疗胆囊息肉并发胆囊结石的疗效及预后效果观察[J].中国现代药物应用, 2016,10(19):85-87.
[7]加雄,李海民,郭震芳.腹腔镜联合胆道镜治疗胆囊息肉合并胆囊结石保胆手术的临床疗效观察[J].临床医学研究与实践, 2016,1(23):40-41.
[8]马灿业,李宝金,廖坚松,等.腹腔镜联合胆道镜治疗胆囊息肉样病变的术后康复情况[J].实用医学杂志, 2016, 32(12):1979-1982.
[9]马建华.老年胆囊息肉患者不同手术治疗对于机体免疫功能的影响[J].中国医药导刊, 2016, 18(6):547-549.
[10]伍贤能,蒋辉,朱叶辉,等.腹腔镜联合胆道镜治疗胆囊息肉并胆囊结石的价值和可行性研究[J].当代医学, 2016,22(8):90-91.