中华腔镜外科杂志（电子版）
中華腔鏡外科雜誌（電子版）
중화강경외과잡지（전자판）
CHINESE JOURNAL OF LAPAROSCOPIC SURGERY ( ELECTRONIC EDITION)
2010年
3期
272-274
,共3页
阎玉矿%赵守和%刘继东%唐滔
閻玉礦%趙守和%劉繼東%唐滔
염옥광%조수화%류계동%당도
肝内胆管结石%腹腔镜%钬激光%胆道镜
肝內膽管結石%腹腔鏡%鈥激光%膽道鏡
간내담관결석%복강경%화격광%담도경
Intrahepatic lithiasis%Laparoscopy%Choledochoscope%Holmium laser
目的 探讨腹腔镜下胆道镜联合钬激光治疗肝内胆管结石的疗效及应用价值.方法 将 40 例肝内胆管结石患者分为两组,对照组 20 例,以传统开腹手术配合术中胆道镜取石;观察组 20 例,以腹腔镜术中胆道镜联合钬激光碎石,比较两组临床疗效.结果 观察组中残余结石完全取净 18 例(90 %),平均手术时间 140 min,平均住院时间 8.3 d,无切口感染,术后残余结石 2 例,经 T 管窦道胆道镜再次取石.对照组取净结石 12 例 (60 %),平均手术时间 125 min,平均住院时间 14.2 d,切口感染 4 例,术后残余结石 8 例,经 T 管窦道配合胆道镜再次取石,其中多次镜下取石 3 例,再次开腹手术 1 例.两组在结石取净率、平均手术次数、切口感染率、平均住院时间的差异有统计学意义(P ＜ 0.01), 平均手术时间差异无统计学意义(P ＞ 0.05).结论 腹腔镜下钬激光联合胆道镜治疗肝内胆管结石,安全、高效、微创.
目的 探討腹腔鏡下膽道鏡聯閤鈥激光治療肝內膽管結石的療效及應用價值.方法 將 40 例肝內膽管結石患者分為兩組,對照組 20 例,以傳統開腹手術配閤術中膽道鏡取石;觀察組 20 例,以腹腔鏡術中膽道鏡聯閤鈥激光碎石,比較兩組臨床療效.結果 觀察組中殘餘結石完全取淨 18 例(90 %),平均手術時間 140 min,平均住院時間 8.3 d,無切口感染,術後殘餘結石 2 例,經 T 管竇道膽道鏡再次取石.對照組取淨結石 12 例 (60 %),平均手術時間 125 min,平均住院時間 14.2 d,切口感染 4 例,術後殘餘結石 8 例,經 T 管竇道配閤膽道鏡再次取石,其中多次鏡下取石 3 例,再次開腹手術 1 例.兩組在結石取淨率、平均手術次數、切口感染率、平均住院時間的差異有統計學意義(P ＜ 0.01), 平均手術時間差異無統計學意義(P ＞ 0.05).結論 腹腔鏡下鈥激光聯閤膽道鏡治療肝內膽管結石,安全、高效、微創.
목적 탐토복강경하담도경연합화격광치료간내담관결석적료효급응용개치.방법 장 40 례간내담관결석환자분위량조,대조조 20 례,이전통개복수술배합술중담도경취석;관찰조 20 례,이복강경술중담도경연합화격광쇄석,비교량조림상료효.결과 관찰조중잔여결석완전취정 18 례(90 %),평균수술시간 140 min,평균주원시간 8.3 d,무절구감염,술후잔여결석 2 례,경 T 관두도담도경재차취석.대조조취정결석 12 례 (60 %),평균수술시간 125 min,평균주원시간 14.2 d,절구감염 4 례,술후잔여결석 8 례,경 T 관두도배합담도경재차취석,기중다차경하취석 3 례,재차개복수술 1 례.량조재결석취정솔、평균수술차수、절구감염솔、평균주원시간적차이유통계학의의(P ＜ 0.01), 평균수술시간차이무통계학의의(P ＞ 0.05).결론 복강경하화격광연합담도경치료간내담관결석,안전、고효、미창.
Objective To investigate the therapeutic effect and application value in the treatment of intrahepatic lithiasis by laparoscopy with choledochoscope and holmium laser. Methods Forty patients who suffered from intrahepatic lithiasis were divided into two groups. Control group, 20 cases were treated by open operation with choledochoscope. Observation group, 20 cases were treated by laparoscopy with choledochoscope and holmium laser laparotomy.Clinical effects were compared between the two groups. Results Observation group: 18 cases had complete removal of all residual stones with the success rate of 90%. Mean operating time was 140 min, Mean hospital stay was 8.3 days, no wound infection. Two cases existed residual stones, were treated by choledochoscope through T tubules sinus tract. Control group: 12 cases had complete removal of all residual stones with the success rate of 60 %. Mean operating time was 125 min, Mean hospital stay was 14.2 days, 4 cases were suffered from wound infection. Eight cases existed residual stones, were treated by choledochoscope through T tubules sinus tract, and 3 cases were recurringly operated calculus removed,1 case was suffered from open operation. There was significant difference in the two groups of patients in the success rate of removal stones, mean operating frequency, incidence of wound infection, mean hospital stay( P ﹤ 0.01 ), and no significant difference in mean operating time( P ﹥ 0.05 ). Conclusions It is safe and effective to treat intrahepatic lithiasis by laparoscopy with cholangioscopy and hiomius laser.
