腹腔镜联合胆道镜治疗胆囊结石合并胆总管结石的安全性和有效性

代盛虎

【摘要】目的：探究在胆囊结石合并胆总管结石治疗中采用腹腔镜+胆道镜联合治疗的临床价值。方法：此次回顾性研究对象共计126例，均为2019年5月-2021年5月于我院实施治疗的胆囊结石合并胆总管结石患者。依据患者在住院治疗期间所用疗法不同划分为对照组和研究组，每组所选病例数一致，均为63例。对比2组患者的治疗安全性及有效性。结果：研究组患者术中及术后各相关指标均优于对照组，且术后使用镇痛药缓解疼痛的例数及感染例数均少于对照组，各指标间对比结果均有较大差异，所得P值均<0.05。结论：在胆囊结石合并胆总管结石治疗中采用腹腔镜+胆道镜联合治疗具有积极地临床价值，值得在临床实践中大力引用。

【关键词】腹腔镜;胆道镜;胆囊结石;胆总管结石

【中图分类号】R657.4 【文献标识码】A 【DOI】

Safety and effectiveness of laparoscopic combination with biliary doscopy in the treatment of gallstone combined with total biliary calculus

Dai Shenghu

（Hepatobiliary Surgery Department， Chongzhou People’s Hospital， Chengdu， Sichuan Province 611230）

【Abstract】Objective： To explore the clinical value of laparoscopy + choledochoscopy in the treatment of cholecystolithiasis combined with common bile duct stones. Methods： a total of 126 patients with cholecystolithiasis combined with common bile duct stones were treated in our hospital from May 2019 to may 2021. The patients were divided into control group and study group according to the different therapies used during hospitalization. The number of cases selected in each group was the same， all 63 cases. The safety and effectiveness of the two groups were compared. Results： the intraoperative and postoperative related indexes of the study group were better than those of the control group， and the number of cases of pain relief and infection with analgesics after operation were less than those of the control group. There were great differences among the comparison results of various indexes， and the obtained P values were all < 0.05. Conclusion： the combination of laparoscopy and choledochoscopy in the treatment of cholecystolithiasis combined with choledocholithiasis has positive clinical value and is worthy of strong reference in clinical practice.

【key words】laparoscopy; Choledochoscopy; Gallstone;Choledocholithiasis

膽囊结石是临床上一种较为常见，且发病率较高的疾病。患者病发期间的胆囊管会长期处于扩张状态，极易导致结石通过胆囊管进入到胆总管中，进而引发胆总管结石[1]。而对于胆囊结石合并胆总管结石患者而言，其实际病情及症状表现情况均与其机体内结石阻塞程度和是否伴有胆道感染有密切联系，如不能及时予以治疗和控制，可会对患者的身心健康产生严重威胁，甚至影响到患者的正常生活。临床上对该类患者的治疗以手术治疗为主，但开腹胆囊切除术与胆总管切开取石术等传统手术治疗方式却存在一些弊端，比如会对患者的机体、机体功能产生一定不良影响等。……