摘要
Abstract
Objective To investigate the optimal therapeutic method of laparoscope in treating choledocholithiasis combined with gallbladder stone. Methods Two hundred and fifty - four patients with choledocholithiasis combined with gallbladder stone who received treatment in the Second Affiliated Hospital of Baotou Medical College from January 2014 to June 2015 were selected. Patients underwent common bile duct exploration were divided into laparoscopic stone extraction( LTSE) group and laparoscopic choledochotomy(LCBDE)group. Patients in LCBDE group after bile duct removal surgery were randomly assigned to primary suture subgroup or T - tube drainage subgroup. The stone clearance rate,occurrence of complication, hospitalization cost and length of stay of patients in two groups were compared. Results Fourteen patients underwent open surgery,172 patients received LTSE,and 68 patients received LCBDE. Among patients in LCBDE,34 cases accepted primary suture and 34 cases T tube drainage. There was no significant difference in gender,age,acute cholecystitis and stone clearance rate between LTSE group and LCBDE group(P > 0. 05);the number of stones and diameter of the stone in LTSE group were less than those in LCBDE group,and the operation time,hospitalization cost and length of stay in LTSE group were shorter than those in LCBDE group( P < 0. 05). There was no significant difference in gender,age,acute cholecystitis,number of stones, diameter of stones and clearance rate of stone between primary suture subgroup and T - tube drainage subgroup(P > 0. 05);the operation time,hospitalization cost and length of stay in primary suture subgroup were shorter than those in T - tube drainage subgroup(P < 0. 05). The incidence rate of biliary complications in LTSE group was lower than that in LCBDE group( χ2= 6. 461,P = 0. 011);there was no significant difference in the incidence rate of other complications between the two groups (χ2 = 3. 682,P = 0. 055);the overall incidence rate of complications in LTSE group was lower than that in LCBDE group(χ2= 11. 332,P = 0. 001). Conclusion For patients with choledocholithiasis combined with gallbladder stone,LTSE should be the preferred treatment plan as it is of low cost and safer and more effective than LCBDE. For patients underwent LCBDE,primary suture is more simple,which can replace T - tube drainage approach.关键词
胆总管结石/胆囊切除术,腹腔镜/胆总管探查术/一期缝合/T 管引流Key words
Choledocholithiasis/Cholecystectomy,laparoscopic/Common bile duct exploration/Primary suture/T- tube drainage分类
医药卫生
