对比双镜联合取石术与腹腔镜切除术治疗胆囊结石的并发症及近期生活质量。

将2015年1月至2018年1月就诊的116例胆囊结石患者纳入本研究，按照随机双盲法分为两组。腹腔镜组58例，接受腹腔镜切除术治疗；双镜组58例，实施腹腔镜联合胆道镜保胆取石术治疗。采用SPSS 21.0软件包校对全组数据，两组患者一期取石率、并发症计数资料用频数、率描述，采用χ²检验；手术相关指标、炎性因子、FACT－G评分计量资料以(±s)描述，采用独立t检验，P<0.05为差异具有统计学意义。

双镜组术中出血量、肛门排气时间、术后24 h疼痛数字评分法(NRS)评分及住院时间比腹腔镜组低(均P<0.05)；两组术后3 d血清IL－6、CRP水平均升高，但双镜组水平比腹腔镜组低(P<0.05)；双镜组一期取石率(94.8%)比腹腔镜组(79.3%)高，并发症发生率(8.6%)比腹腔镜组(22.4%)低(P<0.05)；术后3个月两组FACT－G评分均比术前升高，且双镜组评分(87.1±8.8)分比腹腔镜组(67.3±9.5)分高，差异均有统计学意义(P<0.05)。

相对于腹腔镜切除术而言，双镜联合取石术治疗胆囊结石具有出血量少、一期取石率高、疼痛轻等优势，有助于降低术后炎症反应程度，减少并发症，提高近期生活质量。

To compare the effect of laparoscopic-choledochoscopic gallbladder-preserving lithotripsy and laparoscopic cholecystectomy on complications and short-term living quality in gallstone patients.

116 gallstone patients in our hospital from January 2015 to January 2018 were selected, and they were divided into two groups by randomized double-blinded method. Laparoscopic cholecystectomy was performed in the laparoscopic group (n=58); and laparoscopic-choledochoscopic gallbladder-preserving lithotripsy was performed in the laparoscopic-choledochoscopic group (n=58). SPSS 21.0 software package was used to analyze the data of the whole group. The first-stage success rate of calculus removed and complications in the two groups were described with frequency and rate, and compared with χ² test; The surgical data, inflammatory factors and FACT-G score were recorded by (±s), and compared with independent t test, P<0.05 was considered statistically significant.

The intraoperative bleeding volume, anal exhaust time, postoperative 24 h numerical rating scale (NRS), hospital stays in laparoscopic-choledochoscopic group were lower than those in laparoscopic group (P<0.05); The IL-6 and CRP levels of the two groups at postoperative 3 d were increased, but the levels of laparoscopic-choledochoscopic group were lower than those of laparoscopic group (P<0.05); The first-stage success rate of calculus removed of laparoscopic-choledochoscopic group (94.8%) was higher than laparoscopic group (79.3%), and the incidence of complications (8.6%) was lower than laparoscopic group (22.4%) (P<0.05); After surgery for 3 months, the FACT-G scores of the two groups were increased compared with those before surgery, and the scores of laparoscopic-choledochoscopic group [(87.1±8.8) points] was higher than laparoscopic group [(67.3±9.5) points], and the difference was statistically significant (P<0.05).

Compared with laparoscopic cholecystectomy, laparoscopic-choledochoscopic gallbladder-preserving lithotripsy in treatment of gallstone has advantages such as less bleeding volume, high first-stage success rate of calculus removed and slight pain, it can decrease postoperative inflammatory response, reduce complications and increase short-term living quality.