切换至 "中华医学电子期刊资源库"

中华普外科手术学杂志(电子版) ›› 2018, Vol. 12 ›› Issue (01) : 85 -87. doi: 10.3877/cma.j.issn.1674-3946.2018.01.026

所属专题: 文献

论著

双镜联合微创保胆取石术与腹腔镜胆囊切除术的临床对比研究
甄永强1,(), 徐文样1, 张丽华1, 胡伟能1   
  1. 1. 335400 江西省贵溪市人民医院外一科
  • 收稿日期:2017-05-25 出版日期:2018-02-26
  • 通信作者: 甄永强

Clinical comparison between minimally invasive gallbladder preserving lithotomy combined with choledochoscope and laparoscopic cholecystectomy

Yongqiang Zhen1,(), Wenyang Xu1, Lihua Zhang1, Weineng Hu1   

  1. 1. The First Department of General Surgery, Guixi People’s Hospital of Jiangxi Province, Guixi Jiangxi 335400, China
  • Received:2017-05-25 Published:2018-02-26
  • Corresponding author: Yongqiang Zhen
  • About author:
    Corresponding author: Zhen Yongqiang, Email:
引用本文:

甄永强, 徐文样, 张丽华, 胡伟能. 双镜联合微创保胆取石术与腹腔镜胆囊切除术的临床对比研究[J/OL]. 中华普外科手术学杂志(电子版), 2018, 12(01): 85-87.

Yongqiang Zhen, Wenyang Xu, Lihua Zhang, Weineng Hu. Clinical comparison between minimally invasive gallbladder preserving lithotomy combined with choledochoscope and laparoscopic cholecystectomy[J/OL]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2018, 12(01): 85-87.

目的

探究腹腔镜与胆道镜联合微创保胆取石术与腹腔镜胆囊切除术对胆囊结石的治疗效果。

方法

选取2014年7月至2016年6月就诊的96例胆囊结石患者作为研究对象,随机分为双镜组(腹腔镜联合胆道镜微创保胆取石治疗)和腹腔镜组(腹腔镜胆囊切除治疗),每组各48例。应用SPSS 17.0软件对所有临床数据进行统计学分析,手术情况、术后恢复和肠胃功能恢复时间以均数±标准差表示,组间比较采用独立t检验;术后并发症和复发情况,采用χ2检验;以P<0.05表示差异有统计学意义。

结果

两组患者术中出血量、术后24h疼痛VAS评分、住院时间和复发率比较,差异无统计学意义(P>0.05);与腹腔镜组相比,双镜组手术时间、切口长度、首次排气时间、手术前后胆囊壁厚度差、首次下床活动时间、肠胃功能恢复时间和并发症发生率有明显优势,差异有统计学意义(P<0.05)。

结论

双镜联合微创保胆取石治疗胆囊结石可促进患者术后恢复,控制并发症的发生率,具有一定的临床价值。

Objective

To explore the effect of minimally invasive gallbladder preserving lithotomy combined with choledochoscope and laparoscopic cholecystectomy in the treatment of gallbladder stone.

Methods

96 gallstone patients from July 2014 to June 2016 treated in our hospital were collected and randomly divided into double lens group (minimally invasive gallbladder preserving lithotomy combined with choledochoscope) and the laparoscopic group (laparoscopic resection), 48 cases in each group. Statistical analysis was performed by using SPSS 17.0 software. The recovery circumstances, recovery time and gastrointestinal recovery time were represented in (±s) and compared by t test; The postoperative complications and recurrence were compared using χ2 test; the difference was statistically significant in P<0.05.

Results

There were no significant diffenrence in the amount of bleeding, pain VAS score at postoperative 24h, hospitalization time and recurrence rate between the two groups (P>0.05); Compared with the laparoscopic group, the operation time, incision length, first exhaust time, gallbladder wall thickness before and after the surgery, ambulation time, stomach function recovery time and complication rate in double lens group were better, the differences were statistically significant (P<0.05).

Conclusions

Minimally invasive gallbladder preserving lithotomy combined with choledochoscope can promote the postoperative recovery of patients, reduce the incidence of complications, which has certain clinical value in treatment of gallbladder calculi.

表1 96例胆囊结石患者不同术式两组患者手术情况比较(±s)
表2 96例胆囊结石患者不同术式两组患者术后恢复情况比较(±s)
表3 96例胆囊结石患者不同术式两组术后并发症和复发情况比较(例)
[1]
李帅,张东. 胆囊结石的外科治疗进展[J]. 医学综述,2015, 21(9):1625-1627.
[2]
陈光彬,刘丹峰,刘昌阔,等. 腹腔镜联合胆道镜微创保胆取石术的研究进展[J]. 中国微创外科杂志,2015, 15(12):1133-1135.
[3]
沈志宏,鲁葆春,任培土. 腹腔镜联合胆道镜保胆取石术的临床分析[J]. 中华全科医学,2015, 13(6):1024-1026.
[4]
丁锦辉,刘军乐,罗超英,等. 104例胆囊管结石的诊断和腹腔镜手术治疗的临床分析[J]. 中华普通外科杂志,2015, 30(5):398-399.
[5]
唐飞,王志义,雷浩,等. 全内脏转位经三孔行腔镜胆囊切除术一例[J]. 临床外科杂志,2015, 23(3):240-240.
[6]
王鹏,刘会东,阚永丰. 全腹腔镜下联合胆道镜胆囊切除、胆总管切开探查取石Ⅰ期缝合的可行性研究[J]. 中国社区医师,2016, 32(14):67-69.
[7]
Ha TY, Yoon YI, Hwang S, et al. Effect of Reoperation on Long-Term Outcome of pT1b/T2 Gallbladder Carcinoma After Initial Laparoscopic Cholecystectomy[J]. Journal of Gastrointestinal Surgery, 2015, 19(2):298-305.
[8]
Mohamed MA, Bahram MA, Ammar MS, et al. One-Session Laparoscopic Management of Combined Common Bile Duct and Gallbladder Stones Versus Sequential ERCP Followed by Laparoscopic Cholecystectomy[J]. Journal of Laparoendoscopic & Advanced Surgical Techniques Part A, 2015, 25(6):482-485.
[9]
徐稳深. 腹腔镜胆囊切除术治疗老年急性坏疽性胆囊炎的临床疗效观察[J]. 现代诊断与治疗,2016, 27(5):903-904.
[10]
张明高,谭晓. 腹腔镜切除胆囊术中巨大结石嵌顿32例的处理体会[J/CD]. 中华普外科手术学杂志(电子版), 2017, 11(1):80-83.
[11]
Newman RM, Umer A, Bozzuto BJ, et al. Surgical Value of Elective Minimally Invasive Gallbladder Removal: A Cost Analysis of Traditional 4-Port vs Single-Incision and Robotically Assisted Cholecystectomy[J]. Journal of the American College of Surgeons, 2016, 222(3):303-308.
[12]
黄旭. 胃间质瘤应用双镜联合与单纯腹腔镜治疗的效果对比评估[J]. 当代医学,2017, 23(4):110-111.
[1] 黄竞仪, 周俊志, 双峰, 徐达政. 前交叉韧带与髁间窝的解剖学比较及相关性研究[J/OL]. 中华关节外科杂志(电子版), 2024, 18(01): 86-91.
[2] 康婵娟, 张海涛, 翟静洁. 胰管支架置入术治疗急性胆源性胰腺炎的效果及对患者肝功能、炎症因子水平的影响[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 667-670.
[3] 陈燕. LCBDE和ERCP+EST治疗胆囊结石合并胆总管结石的疗效观察[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(04): 385-388.
[4] 甄子铂, 刘金虎. 基于列线图模型探究静脉全身麻醉腹腔镜胆囊切除术患者术后肠道功能紊乱的影响因素[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(01): 61-65.
[5] 易明超, 汪鑫, 向涵, 苏怀东, 张伟. 一种T型记忆金属线在经脐单孔腹腔镜胆囊切除术中的临床应用[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 599-599.
[6] 易明超, 汪鑫, 向涵, 苏怀东, 张伟. 一种T型记忆金属线在经脐单孔腹腔镜胆囊切除术中的临床应用[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 599-599.
[7] 鲁鑫, 许佳怡, 刘洋, 杨琴, 鞠雯雯, 徐缨龙. 早期LC术与PTCD续贯LC术治疗急性胆囊炎对患者肝功能及预后的影响比较[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 648-650.
[8] 张建波, 东爱华. 不同腹腔镜手术治疗胆囊结石合并胆总管结石的疗效及并发症对比[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 693-696.
[9] 杨雪, 张伟, 尚培中, 宋创业, 尚丹丹, 张蔚. 胆囊十二指肠瘘结石经瘘口排出后自愈一例报道[J/OL]. 中华普外科手术学杂志(电子版), 2023, 17(06): 707-708.
[10] 彭子洋, 王志博, 王丹, 彭浩茜, 王蕾, 彭薇, 王娟娟, 李宇, 刘学民, 吴荣谦, 向俊西, 吕毅. 智能化辅助图像实时去雾技术在腹腔镜胆囊切除术中的应用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(03): 328-333.
[11] 王晓栋, 蔡凤军, 白燕萍, 杨永生. ICG荧光导航在腹腔镜胆囊切除术中应用的关键问题探讨[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(01): 16-20.
[12] 张天献, 吕云福, 郑进方. LC+LCBDE与ERCP/EST+LC治疗胆囊结石合并胆总管结石效果Meta分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(01): 45-50.
[13] 牛朝, 李波, 张万福, 靳文帝, 王春晓, 李晓刚. 腹腔镜袖状胃切除联合胆囊切除治疗肥胖合并胆囊结石安全性和疗效[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12(06): 635-639.
[14] 周后平, 袁源, 欧廷政, 李贝贝, 尚明铭, 姚本能, 宋新, 罗雪梅. 胆囊板Laennec膜间隙逆行分离联合Pringle法在困难胆囊LC术中应用(附视频)[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 540-544.
[15] 张天献, 吕云福, 郑进方. 胆总管结石微创治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12(05): 585-588.
阅读次数
全文


摘要