2型糖尿病患者行腹腔镜胆总管切开取石术临床研究

目的:探讨胆总管结石合并2型糖尿病患者行腹腔镜胆总管切开取石术(LCBDE)的可行性、安全性及有效性.方法:回顾性分析2009年12月-2012年12月采用LCBDE治疗的58例合并2型糖尿病(糖尿病组)及同期58例无糖尿病(非糖尿病组)胆总管结石患者的临床资料,比较两组术前、术中及术后的情况.结果:两组患者手术时间、术中出血量、开始进食时间、术后住院时间及中转开腹方面,差异均无统计学意义(t/x 2=3.921,6.940,1.332,1.270,0.342,均P＞0.05).两组术后电解质紊乱、胆管炎、胆瘘、切口感染、肺部感染发生率比较,差异亦均无统计学意义(×2=0.438,0.537,0.342,1.036,0.342,均P＞0.05).两组均无术后结石残余、胆管狭窄及死亡病例.结论:合并2型糖尿病的胆总管结石患者在围手术期严格控制血糖,术中仔细操作的前提下,行LCBDE是可行的、安全的、有效的.

Laparoscopic common bile duct exploration for stone removal in patients with type 2 diabetes

Objective: To study the feasibility, safety and efficacy of laparoscopic common bile duct exploration (LCBDE) for removal of common bile duct (CBD) stones in patients with concomitant type 2 diabetes. Methods: The clinical data of 58 CBD patients with type 2 diabetes (diabetic group), and another 58 non-diabetic CBD patients (non-diabetic group) undergoing LCBDE procedures from December 2009 to December 2012 were retrospectively analyzed. The pre-, intra- and postoperative conditions between the two groups were compared. Results: Results of the comparisons showed no signi?cant differences between the two groups in the operative time, intraoperative blood loss, time to liquid intake and length of postoperative stay (t/χ2=3.921, 6.940, 1.332, 1.270 and 0.342. all P>0.05), and also no signi?cant differences between the two groups in the incidences of postoperative electrolyte imbalance, cholangitis, bile leakage, wound infection and pulmonary infection (χ2=0.438, 0.537, 0.342, 1.036 and 0.342. all P>0.05). No residual stones, bile duct stricture or death were noted in either group after operation. Conclusion: LCBDE for CBD stone removal in patients with type 2 diabetes, based on the premise of preoperative glycemic control and meticulous surgical technique, is feasible, safe and effective.