CAJ | 학술논문

观察腹腔镜联合胆道镜保胆取石术治疗胆囊结石的临床疗效。将我科收治的158例胆囊结石患者随机分为观察组和对照组，每组79例。观察组行腹腔镜联合胆道镜保胆取石术，对照组行腹腔镜胆囊切除术，比较两组手术情况及相关并发症的发生情况。两组术后均取得满意疗效，无中转开腹治疗病例，术后2w复查结石均取净；两组在手术时间、术中出血量、术后胃肠功能恢复时间、肛门排气时间及住院时间方面无显著差异(>0.05)；两组术后均未出现胆瘘、出血等严重并发症。观察组术中胆管损伤，术后胆汁反流性胃炎、腹胀、腹泻发生率明显低于对照组(<0.05)；两组术后胆总管结石发生率未见明显差异(>0.05)。腹腔镜联合胆道镜保胆取石术治疗胆囊结石临床疗效确切，保留了胆囊的功能，且并发症少，具有良好的安全性，值得临床推广和进一步研究。
관찰복강경연합담도경보담취석술치료담낭결석적림상료효。장아과수치적158례담낭결석환자수궤분위관찰조화대조조，매조79례。관찰조행복강경연합담도경보담취석술，대조조행복강경담낭절제술，비교량조수술정황급상관병발증적발생정황。량조술후균취득만의료효，무중전개복치료병례，술후2w복사결석균취정；량조재수술시간、술중출혈량、술후위장공능회복시간、항문배기시간급주원시간방면무현저차이(>0.05)；량조술후균미출현담루、출혈등엄중병발증。관찰조술중담관손상，술후담즙반류성위염、복창、복사발생솔명현저우대조조(<0.05)；량조술후담총관결석발생솔미견명현차이(>0.05)。복강경연합담도경보담취석술치료담낭결석림상료효학절，보류료담낭적공능，차병발증소，구유량호적안전성，치득림상추엄화진일보연구。
To observe the clinical effects of laparoscopy combined with choledochoscopic gallbladder-preserving cholelithotomy on cholecystolithiasis. Total 158 patients with cholecystolithiasis to receive treatment in our department were randomly divided into observation group and control group (n = 79 per group). The observation group received laparoscopy combined with choledochoscopic gallbladder-preserving cholelithotomy, and the control group received laparoscopic cholecystectomy; the operation status and complications between two groups were compared. The curative effects in both groups were satisfactory after the operation, with no conversion to laparotomy, and it was found that the stones had been completely removed according to the examination in 2 w after the operation; there was no significant difference in the operation time, intraoperative bleeding volume, postoperative gastrointestinal function recovery time, anal exhaust time and hospitalization time between two groups ( > 0.05); there were no serious complications, such as biliary fistula and hemorrhage after the operation in both groups. The incidences of postoperative bile duct injury and bile reflux gastritis, abdominal distension and diarrhea in the observation group were significantly lower than those in the control group ( < 0.05), but the incidence of postoperative common bile duct calculi showed no significant difference between the two groups ( > 0.05). Laparoscopy combined with choledochoscopic gallbladder-preserving cholelithotomy has definite clinical curative effect in the treatment of cholecystolithiasis; it retains the function of gallbladder and has fewer complications and good safety, and is worthy of clinical promotion and further research.