CAJ | 학술논문

目的：比较腹腔镜联合胆道镜保胆取石术和腹腔镜胆囊切除术治疗胆囊结石的临床疗效。方法将2013年10月～2015年10月确诊为胆囊结石的105例患者分为腹腔镜联合胆道镜保胆取石术组（50例）和腹腔镜胆囊切除组（55例）。保胆取石术组患者术前均行检查证实胆囊收缩功能正常。比较两组的手术时间、术中出血量、术后胃肠蠕动恢复时间、并发症、住院时间、住院费用及随访情况的差异。结果保胆取石组平均手术时间、住院时间、住院费用与胆囊切除组比较无统计学意义（ P＞0．05），术中出血量和术后胃肠蠕动恢复时间，保胆取石组明显优于腹腔镜胆囊切除组（P＜0．05）。两组术后均无出血、残留结石、腹腔感染、胆漏、胆总管继发结石等并发症发生。随访3～12个月期间，两组均无结石复发。结论腹腔镜联合胆道镜保胆取石术具有安全、有效、创伤小、康复快等优点，同时保持了胆囊功能及胆道完整性，具有良好的应用前景。
목적：비교복강경연합담도경보담취석술화복강경담낭절제술치료담낭결석적림상료효。방법장2013년10월～2015년10월학진위담낭결석적105례환자분위복강경연합담도경보담취석술조（50례）화복강경담낭절제조（55례）。보담취석술조환자술전균행검사증실담낭수축공능정상。비교량조적수술시간、술중출혈량、술후위장연동회복시간、병발증、주원시간、주원비용급수방정황적차이。결과보담취석조평균수술시간、주원시간、주원비용여담낭절제조비교무통계학의의（ P＞0．05），술중출혈량화술후위장연동회복시간，보담취석조명현우우복강경담낭절제조（P＜0．05）。량조술후균무출혈、잔류결석、복강감염、담루、담총관계발결석등병발증발생。수방3～12개월기간，량조균무결석복발。결론복강경연합담도경보담취석술구유안전、유효、창상소、강복쾌등우점，동시보지료담낭공능급담도완정성，구유량호적응용전경。
[ ABSTRACT] Objective To compare the clinical effect of laparoscopic cholecystectomy and laparoscopic gallbladder-preserving li-thotomy surgical treatment for cholecystolithiasis.Methods In the cholecystolithiasis data of 105 patients in our hospital from October 2013 to October 2015,50 patients were taked by laparoscopic gallbladder-preserving lithotomy combined with choledochoscope.In addition,55 pa-tients were treated by laparoscopic cholecystectomy.Laparoscopy combined with choledochoscope group had been tested with well contractile function of gallbladder.The operative time,bleeding volume,enterokinesia recovery time,post-operative complication,the days in hospital, hospital costs and follow-up of the two groups were compared and analyzed.Results There was no statistical difference between the two groups in the operative time,postoperative days and hospital charge(P>0.05).In perioperative bleeding and postoperative passing gas time, cholecystolithotomy group is obviously superior to laparoscopic cholecystectomy group(P<0.05).In these two groups,there were no compli-cations such as hemorrhage,residual calculi,abdominal infection,bile leakage or secondary choledocholithiasis ect.All patients were followed up for 3~12 months with no stone recurrence.Conclusion It is a safe and efficient procedure with less damage and rapid recovery to treat cholecyst stone by laparoscopic gallbladder-preserving lithotomy for good function of gallbladder and preservation of normal function of the cholecyst.