文档介绍：腹腔镜并内镜与开腹手术治疗胆囊胆总管结石效果比较
【摘要】目的比较腹腔镜胆囊切除术(LC)及内镜乳头肌切开术(EST)联合治疗胆囊胆总管结石与开腹行胆囊切除、胆总管切开取石术并置T管引流术的疗效。方法回顾性分析2004年3月~2006年10月行LC+EST病人40例及同期行开腹手术病人41例的手术方法、临床疗效,并进行比较。结果 LC+%(37/40),开腹组手术全部成功。LC+EST组病人切口长度、术后进食时间、住院时间皆小于开腹手术组,差异有显著性(t=~,P<)。结论 LC+EST治疗胆囊胆总管结石具有创伤小、恢复快的特点,但有一定局限性。
【关键词】胆囊结石病胆总管结石腹腔镜检查剖腹术
[ABSTRACT]pare the therapeutic efficacy of laparosopic cholecystectomy (LC) combined with endoscopic sphincterotomy (EST) versus open data of 40 patients with cholelithiasis receiving LC and EST (group Ⅰ) were reviewed retrospectively pared with 41 cases underwent open surgery (group Ⅱ).ResultsOperation ess rate was % (37/40) in group Ⅰ, the length of incision and patients’ hospital stay were significantly shorter than those of group Ⅱ(t=-,P<).pared with open surgery, LC+EST is of less invasion and quicker recovery, but, there are certain limitations.
[KEY WORDS]cholelithiasis; choledocholithiasis; laparoscopy; laparotomy
胆囊胆总管结石是普外科的常见病,近年来由于微创技术与影像学的发展,其治疗方式亦有了长足的进步。我们采用腹腔镜胆囊切除术(LC)联合内镜乳头肌切开术(EST)治疗此病,并与传统的开腹行胆囊切除、胆总管切开取石术并置T管引流术的效果进行比较,现报告如下。
1 资料与方法
对象与分组
2004年3月~2006年10月,我院普外科收治的胆囊胆总管结石病人81例,均经B超、CT或经内镜逆行胆胰管造影(ERCP)确诊,胆总管结石直径< cm,数量少于4枚,无肝内胆管结石,无上腹手术史。随机分为LC+EST组和开腹手术组。LC+EST组40例术中中转开腹3例,最后入组37例,男17例,女20例;年龄16~81岁,平均(±)岁;体质量(±)kg。单发胆囊结石及胆总管结石病人分别为5例和10例;胆囊结石直径