腹腔镜联合开腹胆道探查器械行胆总管探查取石术的临床研究

目的：探讨腹腔镜联合开腹胆道探查器械行胆总管探查取石术的可行性与临床应用价值。方法：2009年1月至2013年1月收治90例胆囊结石合并胆总管结石患者,随机分为两组（n=45）,观察组采用腹腔镜联合开腹胆道探查器械行胆总管探查取石术,对照组行传统开腹手术。结果：两组患者取石成功率相当,差异无统计学意义（P〉0.05）;观察组手术时间、住院时间、肛门排气时间、患者满意度、并发症发生率均优于对照组,差异有统计学意义（P〈0.05）。结论：腹腔镜联合开腹胆道探查器械行胆总管探查取石术具有患者创伤小、并发症少、住院时间短、患者满意度高等优点,应用范围广,具有较好的临床应用价值。

The clinical study of laparoscopic common bile duct exploration and removal of stones with open bile duct exploration instruments

Objective ： To investigate the feasibility and clinical value of laparoscopic common bile duct exploration and removal of stones with open bile duct exploration instruments. Methods：From Jan. 2009 to Jan. 2013,90 patients with cholecystolithiasis and eholedocholithiasis were randomly divided into two groups. The observation group （45 patients） underwent common bile duct exploration and removal of stones with iaparoscopy combined with iaparotomy bile duct exploration instruments, and the control group （4-5 patients） underwent conventional laparotomy. Results ： There was no significant difference in success rate of stone removal （ P 〉 0.05 ）. The oper- ative time, hospitalization time, anal exhaust time, the sati＇sfactiou rate and complication rate in the observation group were significantly superior to those of the control group （ P 〈 0.05 ）. Conclusions ： Common bile duct exploration and removal of stones with laparoscopy combined with laparotomy bile duct exploration instruments has advantages of mini-invasion, few complications, short hospital stay and high satisfaction rate. It has a wide range of application and better clinical value.