腹腔镜胆道镜胆总管探查取石术治疗胆结石的临床效果观察

目的：探讨腹腔镜联合胆道镜进行胆总管探查取石（LCBDE）治疗肝内胆管结石的临床疗效。方法：将73例患者分为37例LCBDE组和36例开腹手术组（对照组），比较两组患者手术时间、术后可以进食时间、住院天数、ICU入住率、医疗费用（万元）以及术后并发症等情况。结果：两组在住院天数方面差异无统计学意义（P〉O．05）；LCBDE组的手术时间、术后ICU入住率明显少于或低于对照组，两组数据相比差异皆有显著统计学意义（P〈0．01）；LCBDE组患者术后可以进食时间、医疗费用都比对照组要短或低（P〈0．05）。两组患者术后并发症比较差异有显著统计学意义（P〈0．01）。结论：LCBDE治疗胆结石无论是治疗效果还是在降低医疗花费方面都要比传统开腹手术有优势，值得临床进一步推广。

Clinical Effect of Laparoscopic and Cholangioscopic Lithotomy of Common Bile Duct Exploration in Treatment of Cholelithiasis

Objective： To explore clinical curative effect of laparoscopy combined with choledochoscopy for bile duct stones （ LCBDE ） in the treatment of intrahepatic bile duct stones. Method ： 73 patients were divided into 37 cases of LCBDE group and 36 cases of open operation group （control group ）, The time of operation, postoperative diet and hospitalization, ICU occu- pancy rate, medical expenses （ million ） and postoperative complications in the two groups were compared. Result： There was no significant difference between the two groups hospitalization days （ P〉O. 05 ） ; Operation time, the occupancy rate of ICU of LCBDE group was less than than those of the control group, The data of the two groups had significant statistical significance difference （ P 〈0.01 ） ; LCBDE group patients eating time, medical expenses were shorter than the control groupC P 〈0.05 ）. There was significant difference in two groups of patients with postoperative complications （ P 〈0. Ol ）. Conclusion： LCBDE treatment of gallstones either in effect of treatment or in reducing medical costs has more advantages than traditional open opera- tion, is worthy of further oromotion.