CAJ | 학술논문

　　目的探讨腹腔镜下胆道镜联合螺旋水刀碎石治疗肝内胆管结石的临床疗效和应用价值。方法比较51例腹腔镜下胆道镜联合螺旋水刀治疗肝内胆管结石和56例开腹手术下胆道镜联合螺旋水刀治疗肝内胆管结石的临床资料，观测指标有结石清除率、手术时间、术后镇痛、肛门排气时间、术后并发症等。结果两组患者在结石清除率、性别、年龄、结石大小等比较差异无统计学意义。开腹组和腹腔镜组患者在手术时间（min）（150.3±36.5 vs 176.4±41.1，P =0.003）、术后镇痛（41例vs 14例，P =0.005）、肛门排气时间（h）（57.2±13.7 vs 29.1±8.1，P =0.000）、术后并发症（18例vs 5例，P =0.009）等方面比较，差异有统计学意义。结论腹腔镜下胆道镜联合螺旋水刀碎石治疗肝内胆管结石是安全、微创、有效的方法。
　　목적탐토복강경하담도경연합라선수도쇄석치료간내담관결석적림상료효화응용개치。방법비교51례복강경하담도경연합라선수도치료간내담관결석화56례개복수술하담도경연합라선수도치료간내담관결석적림상자료，관측지표유결석청제솔、수술시간、술후진통、항문배기시간、술후병발증등。결과량조환자재결석청제솔、성별、년령、결석대소등비교차이무통계학의의。개복조화복강경조환자재수술시간（min）（150.3±36.5 vs 176.4±41.1，P =0.003）、술후진통（41례vs 14례，P =0.005）、항문배기시간（h）（57.2±13.7 vs 29.1±8.1，P =0.000）、술후병발증（18례vs 5례，P =0.009）등방면비교，차이유통계학의의。결론복강경하담도경연합라선수도쇄석치료간내담관결석시안전、미창、유효적방법。
Objective To investigate the effect and application in the treatment of intrahepatic lithiasis by laparoscopy with choledochoscope and helix hydro-jet. Methods A prospective comparison was conducted between 51 patients treated by laparoscopy with choledochoscope and helix hydro-jet and 56 by open operation with choledochoscope and helix hydro-jet. Such terms as stone removal, operation time, postoperative analgesia, postoperative anus exhaust time, and postoperative complications were taken into consideration. Results The two groups of patients have no statistically significant differences on stone clearance rate , gender , age, and stone size, whereas operation time, postoperative analgesia, anal exhaust time, and postoperative complications show significant differences (P < 0.01). Conclusion It is safe, effective and minimally invasive to treat intrahepatic lithiasis by laparoscopy with choledochoscope and helix hydro-jet.