CAJ | 학술논문

目的：探讨对肝内外胆道结石患者采用腹腔镜联合胆道镜治疗的效果及安全性。方法选择2010年5月至2013年5月我院收治的80例肝内外胆道结石患者作为临床观察对象。按照患者的意愿分为治疗组（40例）与对照组（40例）。治疗组给予腹腔镜与胆道镜联合治疗，对照组给予常规的开腹手术治疗。主要观察两组患者手术时间、手术出血量、术后下床活动时间、术后并发症率及住院天数等治疗指标。结果治疗组在手术时间、术后下床活动时间及住院天数方面，用时均显著短于对照组（ P＜0．05）；治疗组手术出血量也比对照组少，两组比较差异具有统计学意义（P＜0．05）；治疗组术后出现胆道出血2例，胆源性胰腺炎1例，感染1例，总并发症率为10％，对照组出现胆漏2例，胆道出血5例，胆源性胰腺炎2例，感染3例，总并发症率是30％，两组并发症率比较差异显著（ P＜0．05）。结论采用腹腔镜联合胆道镜实施肝内外胆道结石手术，具有比开腹手术创伤小、术中出血量少、术后并发症少等优势，安全有效，疗效确切，此法值得临床推广应用。
목적：탐토대간내외담도결석환자채용복강경연합담도경치료적효과급안전성。방법선택2010년5월지2013년5월아원수치적80례간내외담도결석환자작위림상관찰대상。안조환자적의원분위치료조（40례）여대조조（40례）。치료조급여복강경여담도경연합치료，대조조급여상규적개복수술치료。주요관찰량조환자수술시간、수술출혈량、술후하상활동시간、술후병발증솔급주원천수등치료지표。결과치료조재수술시간、술후하상활동시간급주원천수방면，용시균현저단우대조조（ P＜0．05）；치료조수술출혈량야비대조조소，량조비교차이구유통계학의의（P＜0．05）；치료조술후출현담도출혈2례，담원성이선염1례，감염1례，총병발증솔위10％，대조조출현담루2례，담도출혈5례，담원성이선염2례，감염3례，총병발증솔시30％，량조병발증솔비교차이현저（ P＜0．05）。결론채용복강경연합담도경실시간내외담도결석수술，구유비개복수술창상소、술중출혈량소、술후병발증소등우세，안전유효，료효학절，차법치득림상추엄응용。
Objective To investigate the application efficacy of laparoscope combined with choledochoscope in the treatment of internal/external biliary calculi and it's safety.Methods Totally 80 cases ofpatients suffered from internal/external biliary calculi were included in this study , and they were divided into treatment group ( n=40 ) and control group ( n =40 ) according to their own will .Patients in treatment group received therapy under laparoscopeand choledochoscope , while patients in control group received conventional surgical therapy .Record the operation time , amount of bleeding , postoperative ambulation time , postoperative complication rate and hospitalize time .Results Operative time, postoperative ambulation time and hospitalize time of the treatment group were significantly shorter than the control group , and the amount of bleeding of treatment group was less than the control group (P<0.05).The total complication rate in treatment group was 10%( including 2 cases of biliary tract bleeding .one case of biliary pancreatitis and one case of infection ) , and the total complication rate in control group was 30%( including 5 cases of biliary tract bleeding .2 case of biliary pancreatitis and 3 case of infection), complication rate between the two groups significantly different (P<0.05). Conclusions Laparoscopecombined with choledochoscope was effective and safe in the treatment of biliary calculi for it had the advantages such as little trauma , less blood loss , fewer complications .Itis worthy of clinical application .