CAJ | 학술논문

目的：探讨腹腔镜联合胆道镜保胆取石术治疗胆囊结石的临床应用价值及可行性。方法收集该院2010年2月至2013年2月收治的胆囊结石患者94例，46例采用腹腔镜联合胆道镜保胆取石术（EM IC组），48例采用腹腔镜胆囊切除术（LC组）。比较两组手术时间、术中出血量、术中胆管损伤发生率、术后肛门排气时间、平均住院日、术后胆汁反流性胃炎发生率、术后腹胀、腹泻发生率、术后胆总管结石的发生率及住院费用等。结果两组手术时间、住院费用、平均住院日及术中出血量比较，差异无统计学意义（P＞0．05）；而术后肛门排气时间、胆总管结石发生率、术中胆管损伤发生率、胆汁反流性胃炎发生率及腹胀、腹泻发生率比较，EMIC组均明显小于LC组（P＜0．05）。结论 EMIC组与LC组相比，具有安全性高、痛苦轻、康复快、并发症少等优点，既达到了微创治疗的目的，又保持了胆道的完整性及胆囊功能。
목적：탐토복강경연합담도경보담취석술치료담낭결석적림상응용개치급가행성。방법수집해원2010년2월지2013년2월수치적담낭결석환자94례，46례채용복강경연합담도경보담취석술（EM IC조），48례채용복강경담낭절제술（LC조）。비교량조수술시간、술중출혈량、술중담관손상발생솔、술후항문배기시간、평균주원일、술후담즙반류성위염발생솔、술후복창、복사발생솔、술후담총관결석적발생솔급주원비용등。결과량조수술시간、주원비용、평균주원일급술중출혈량비교，차이무통계학의의（P＞0．05）；이술후항문배기시간、담총관결석발생솔、술중담관손상발생솔、담즙반류성위염발생솔급복창、복사발생솔비교，EMIC조균명현소우LC조（P＜0．05）。결론 EMIC조여LC조상비，구유안전성고、통고경、강복쾌、병발증소등우점，기체도료미창치료적목적，우보지료담도적완정성급담낭공능。
Objective To discusses the clinical application value and safety of endoscopic minimally invasive cholecystolithotomy in gallstones treatment .Methods To retrospectively analyzes the clinical data of 94 patients with gallbladder stone from Feb .2010 to Feb .2013 ,and divided into endoscopic minimally invasive cholecystolithotomy (EMIC) group (46 cases) and laparoscopic chole-cystectomy (LC) group (48 cases) .Observed two groups of operation time ,intraoperative blood loss ,intraoperative bile duct inju-ry ,anal exhaust time ,postoperative hospitalization time ,bile reflux gastritis ,abdominal distention ,diarrhea ,common bile duct calculi and hospitalization expenses ,etc .Results Two groups of operation time ,hospitalization expenses ,length of hospital stay ,and intra-operative blood loss have no obvious difference(P>0 .05) ,in EMIC set ,the exhaust time ,postoperative bile duct calculi incidence , intraoperative bile duct injury ,bile reflux gastritis incidence and the incidence of abdominal distension ,diarrhea are significantly less than LC group (P<0 .05) .Conclusion The endoscopic minimally invasive cholecystolithotomy compared with laparoscopic chole-cystectomy had high security ,light pain ,quicker recovery ,less complications advantages .It has already achieved the purpose of min-imally invasive treatment ,while maintaining the integrity of bile duct and gallbladder function ,thus it is worthy of promoting .