腹腔镜胆道镜联合取石一期胆总管缝合对老年胆总管结石伴胆囊结石的疗效
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陕西省重点研发计划项目(2017SF-232);


Efficacy of laparoscopy with choledochoscopy for lithotomy combined with primary duct closure on elderly common bile duct stones with gallbladder stones
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    摘要:

    目的:分析腹腔镜胆道镜联合取石一期胆总管缝合(PDC)对老年胆总管结石(CBDS)伴胆囊结石的临床疗效。方法:回顾性收集102例老年CBDS伴胆囊结石患者的临床资料,按治疗方案不同将患者分为A组(行腹腔镜胆道镜联合取石+PDC治疗,n=51)和B组(行腹腔镜胆道镜联合取石+T管引流治疗,n=51)。比较两组患者手术相关指标、术后72 h肝功能和炎症应激指标水平,记录两组患者并发症发生情况及术后复查情况。结果:A组手术用时、肛门排气时间和住院时间均短于B组(P<0.05),住院总费用少于B组(P<0.05)。术后72 h,两组患者ALP、TBIL水平均低于术前(P<0.05),IL-6、CRP、E和Cor水平均高于术前(P<0.05),但A组上述各指标水平均低于B组(P<0.05)。两组患者并发症总发生率及术后复查情况无统计学差异(P>0.05)。结论:老年CBDS伴胆囊结石的腹腔镜胆道镜联合取石术中应用PDC与T管引流治疗的远期效果相当,但PDC在缩短手术和住院时间、促进术后恢复、改善肝功能和炎症反应方面更具优势。

    Abstract:

    Objective:To analyze the clinical efficacy of laparoscopy with choledochoscopy for lithotomy+primary duct closure(PDC)on elderly common bile duct stones(CBDS)with gallbladder stones.Methods:102 elderly patients with CBDS and gallbladder stones in the hospital were retrospectively collected.According to different treatment regimens,the enrolled patients were divided into group A(laparoscopy with choledochoscopy for lithotomy+PDC therapy,n=51)and group B(laparoscopy with choledochoscopy for lithotomy+T tube drainage,n=51).The surgery-related indicators,liver function and inflammatory stress indicators at 72 h after sur-gery were compared between groups of patients,and the incidence rates of complications and postoperative review conditions were recor-ded in the two groups of patients.Results:The surgical time,anal exhaust time and hospital stay in the group A were shorter than those in the group B(P<0.05),and the total hospitalization cost was less than that in the group B(P<0.05).The levels of ALP and TBIL in both groups were lower at 72 h after surgery than those before surgery(P<0.05)while the levels of IL-6,CRP,E and Cor were higher than those before surgery(P<0.05),but the levels of the above indicators were lower in the group A than those in the group B(P<0.05).There were no statistical differences in the total incidence rate of complications and postoperative review conditions be-tween the two groups(P>0.05).Conclusion:The long-term effects of PDC and T tube drainage during laparoscopy with choledochos-copy for lithotomy are similar in the treatment of elderly CBDS with gallbladder stones,but PDC has more advantages in shortening sur-gical time and hospital stay,promoting postoperative recovery and improving liver function and inflammatory stress response.

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赵宝国;周党军;王羊;韩博强;.腹腔镜胆道镜联合取石一期胆总管缝合对老年胆总管结石伴胆囊结石的疗效[J].川北医学院学报,2025,40(7):840-844.

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  • 在线发布日期: 2025-08-10
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