CAJ | 학술논문

目的：探讨腹腔镜联合胆道镜钬激光肝胆管碎石临床治疗效果。方法选取2011年1月～2014年11月我院肝胆外科收治的112例肝胆管结石患者随机分为对照组和观察组，分别采用传统开腹手术和腹腔镜联合胆道镜钬激光治疗，比较两组患者取石效果、手术时间、术中出血量、住院时间及并发症发生情况。结果观察组术后结石残留率为5.36％明显低于对照组19.64％残留率，比较有统计学意义（P＜0.05）；观察组手术时间、术中出血量及住院时间均少于对照组，各值比较有统计学意义（P＜0.05）；观察组并发症发生率为5.36％明显低于对照组17.86％的发生率，比较有统计学意义（P＜0.05）。结论腹腔镜联合胆道镜钬激光治疗肝胆管结石具有较高的取石效果，能缩短手术时间、减少术中出血量、住院时间及并发症发生率，值得在临床中推广应用。
목적：탐토복강경연합담도경화격광간담관쇄석림상치료효과。방법선취2011년1월～2014년11월아원간담외과수치적112례간담관결석환자수궤분위대조조화관찰조，분별채용전통개복수술화복강경연합담도경화격광치료，비교량조환자취석효과、수술시간、술중출혈량、주원시간급병발증발생정황。결과관찰조술후결석잔류솔위5.36％명현저우대조조19.64％잔류솔，비교유통계학의의（P＜0.05）；관찰조수술시간、술중출혈량급주원시간균소우대조조，각치비교유통계학의의（P＜0.05）；관찰조병발증발생솔위5.36％명현저우대조조17.86％적발생솔，비교유통계학의의（P＜0.05）。결론복강경연합담도경화격광치료간담관결석구유교고적취석효과，능축단수술시간、감소술중출혈량、주원시간급병발증발생솔，치득재림상중추엄응용。
Objective To explore the clinical curative effect of the holmium laser in the treatment of hepatolithiasis through laparoscopy combined with choledochoscope.Methods112 patients with hepatolithiasis who were admitted to the department of hepatobiliary surgery of our hospital from January 2011 to December 2014 were randomly allocated to control group and observation group that was treated with traditional laparotomy and the holmium laser through laparoscopy combined with choledochoscope respectively. Stone-free effect, duration of operation, intraoperative blood loss, length of stay and occurrence of complications of two groups were compared.Results Calculi residual rate of observation group was 5.36%, which was significantly lower than 19.64% of control group, and the difference was statistically significant (P<0.05). Duration of operation, intraoperative blood loss and length of stay were all shorter and fewer than those of control group, and the differences were statistically significant (P<0.05). The occurrence rate of complication of observation group was 5.36%, which was significantly lower than 17.86% of control group, and the difference was statistically significant (P<0.05).Conclusion The holmium laser in the treatment of hepatolithiasis through laparoscopy combined with choledochoscope has great stone-free effect including shortening duration of operation and length of stay, reducing intraoperative blood loss and lower the occurrence rate of complication, which is worthy of clinical promotion and application.