腹腔镜、胆道镜及选择性十二指肠镜联合手术治疗胆囊结石合并胆总管结石

doi:10.16260/j.cnki.1009-2188.2018.02.007

中国现代手术学杂志

2018, Vol. 22

Issue (2): 109-112 DOI: 10.16260/j.cnki.1009-2188.2018.02.007

临床论著

腹腔镜、胆道镜及选择性十二指肠镜联合手术治疗胆囊结石合并胆总管结石

苏士珂1，周旭2

1.德州市齐河县人民医院普通外科，山东德州 251100；2.山东省立医院肝胆外科，山东济南 250021

The Effect of Laparoscopy Combined with Choledochoscopy and Selective Duodenoscopy in the Treatment ofCholecystolithiasis Complicated with Choledocholithiasis

SU Shi-ke1, ZHOU Xu2　

1.Department?of?General?Surgery,?People's?Hospital?of?Qihe?County,?Dezhou?251100,?Shandong,?China;2.?Department?of?Hepatobiliary?Surgery,?Shandong?Provincial?Hospital,?Jinan?250021,?Shandong,?China

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摘要目的　研究腹腔镜、胆道镜及选择性十二指肠镜联合应用对胆囊结石合并胆总管结石患者的疗效。　方法　我院从2015年4月到2017年4月有58例胆囊结石合并胆总管结石患者就诊。以数字表法随机分成观察组(29例)和对照组(29例)。其中观察组给予腹腔镜、胆道镜及选择性十二指肠镜联用术式治疗，对照组给予腹腔镜联合十二指肠镜术式治疗。　结果　观察组患者手术时间和住院时间，术中出血量以及术后肛门恢复通气时间均显著少于对照组；观察组患者结石完全清除率显著高于对照组(均P<0.05)；两组患者术后并发症发生率差异无显著意义(均P>0.05)。　结论　腹腔镜、胆道镜及选择性十二指肠镜联用术式对胆囊结石合并胆总管结石患者不仅有效降低患者手术时间、住院时间，减少出血量等，还能提高结石清除率，减少并发症，值得临床推广。

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	苏士珂1，周旭2

关键词: 腹腔镜　胆道镜　十二指肠镜　胆囊结石　胆总管结石

Abstract: Objective　To study the effect of laparoscopy, choledochoscopy and selective duodenoscopy in the treatment of cholecystolithiasis complicated with choledocholithiasis.　Methods　From April 2015 to April 2017, 58 patients complicated with cholecystolithiasis and choledocholithiasis were treated in our hospital, who were randomly divided into the observation group (29 cases) and the control group (n=29). The observation group was treated with laparoscopy, choledochoscopy and selective duodenal endoscopy, while the control group was treated with laparoscopy combined with duodenoscopy. The curative effect, operation and hospitalization time, intraoperative blood loss, VAS score and complications were compared between the two groups.　Results　It was significantly lower of the numerical value of operation time and hospitalization time, bleeding volume and intestinal recovery time of the observation group than that of the control group(P<0.05). The total clearance rate of calculi in the observation group was significantly higher than that of the control group (P<0.05). And there was no significant difference in the incidence of postoperative complications between the two groups (all?P>0.05).　Conclusion　The combined application of laparoscopy, choledochoscopy and selective duodenoscopy for the treatment of cholecystolithiasis and choledocholithiasis patients can not only reduce operative time, hospitalization time and the amount of bleeding, but also can increase the stone clearance rate, which is worthy of clinical promotion.

Key words: laparoscopy 　choledochoscopy 　duodenoscopy 　cholecystolithiasis 　choledocholithiasis

出版日期: 2018-04-26 发布日期: 2018-08-14 期的出版日期: 2018-04-26

ZTFLH:	R575.6
	R657.4

通讯作者: 周旭，男，48岁，山东省立医院肝胆外科主任医师，医学博士，硕士研究生导师。

作者简介: 苏士珂，男 ,50岁，德州市齐河县人民医院普通外科副主任医师，医学硕士。

引用本文:

苏士珂1，周旭2. 腹腔镜、胆道镜及选择性十二指肠镜联合手术治疗胆囊结石合并胆总管结石[J]. 中国现代手术学杂志, 2018, 22(2): 109-112.
SU Shi-ke. The Effect of Laparoscopy Combined with Choledochoscopy and Selective Duodenoscopy in the Treatment ofCholecystolithiasis Complicated with Choledocholithiasis. Chinese Journal of Modern Operative Surgery, 2018, 22(2): 109-112.

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http://www.surgerychina.com/CN/10.16260/j.cnki.1009-2188.2018.02.007 或 http://www.surgerychina.com/CN/Y2018/V22/I2/109

[1]　刘燕南, 陈剑, 贺修文, 等. 3D与2D腹腔镜经胆囊管汇入部微切开胆道探查的对比研究[J]. 中华普通外科杂志, 2016,31(3):224-226.|[2]　杜军卫, 靳君华, 胡文秀, 等. 胆囊结石继发肝外胆管结石的三种术式比较[J]. 中华医学杂志, 2017,97(4):276-279.|[3]　王亮, 折占飞, 乔宇, 等. 腹腔镜联合胆道镜经胆囊管探查治疗胆囊结石合并胆总管结石[J]. 中国微创外科杂志, 2017,17(2):189-192.|[4]　王广义, 蒋超. “三镜”联合治疗肝外胆管结石[J]. 腹部外科, 2013, 26(5):294-295.|[5]　孙晓东, 邱伟, 吕国悦, 等. 2364例肝外胆管结石三镜联合微创外科治疗的临床疗效[J]. 中华消化外科杂志, 2016, 15(4):357-362.|[6]　温治强, 宋越, 张耀明, 等. 腹腔镜联合胆道镜、十二指肠镜治疗胆囊结石合并肝内外胆管结石的效果观察[J]. 临床肝胆病杂志, 2016, 32(6):1145-1148.|[7]　张永杰. 对“2364例肝外胆管结石三镜联合微创外科治疗的临床疗效”的点评[J]. 中华消化外科杂志, 2016, 15(4):362-362.|[8]　陈见中, 汪有宝, 陈章彬, 等. 腹腔镜下经胆囊管胆总管探查术与胆总管切开探查术的疗效比较[J]. 肝胆胰外科杂志, 2017,29(1): 57-59.|[9]　杨大卫, 傅继宁. 腹腔镜胆囊切除术(LC)与经十二指肠镜逆行胆胰管造影(ERCP)联合治疗肝外胆管结石合并胆囊结石的临床价值[J]. 浙江创伤外科, 2016, 21(10X):12.|[10] 陈永标, 池小斌, 江艺, 等. 腹腔镜肝切除联合胆道镜治疗肝内外胆管结石36例[J]. 中国微创外科杂志, 2016, 16(9):777-779.|[11] 赵云, 杨成林, 冯以斌, 等. 十二指肠镜联合腹腔镜治疗老年胆囊结石合并肝外胆管结石[J]. 中国普通外科杂志, 2016, 25(8):1105-1111.|[12] 梁钰安, 周文策, 钱春花, 等. 腹腔镜胆囊切除术与保胆取石术患者胆道感染的对比分析[J]. 中华医院感染学杂志, 2016,26(6):1286-1288.|[13] 石玉琪, 许春芳. ERCP联合腹腔镜胆囊切除术治疗胆总管结石合并胆囊结石术后胆总管结石复发的危险因素分析[J]. 中华消化内镜杂志, 2016,33(10):689-692.|[14] 桂亮, 刘晔, 秦骏, 等. 腹腔镜手术治疗胆囊结石伴肝硬化的疗效观察[J]. 中华腔镜外科杂志(电子版),2016,9(3):175-179.

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