目的 观察腹腔镜及选择性辅助小切口行胆管探查在肝外胆管结石治疗中的效果。方法 选择2016年9月—2019年3月期间收治的70例肝内外胆管结石,其中对照组35例采取开腹胆管探查治疗,观察组35例实施腹腔镜及选择性辅助小切口胆管探查,对比观察两组患者的手术情况、T管引流量、胆总管压力及并发症。结果 两组患者胃肠道恢复时间、术后1 d T管引流量和胆总管压力、术后结石残余、胆漏均无差异;观察组在出血量、胃肠道恢复时间及住院时间、术后7 d T管引流量、胆总管压力均优于对照组,切口感染低于对照组(2.86% 对14.29%,P＜0.05)。结论 腹腔镜及选择性辅助小切口行胆管探查治疗于肝内外胆管结石,手术出血量较低,胃肠道恢复快,并发症较少,值得推广。

Objective To observe the therapeutic effect of bile duct exploration via laparoscopic-assisted selective small incision on extrahepatic bile duct stones.Methods A total of 70 patients with intrahepatic and extrahepatic bile duct stones treated from September 2016 to March 2019 in our hospital were devided into observation group and control group according to different therapies, with 35 cases in each group.The control group received bile duct exploration via laparotomy, and the observation group received bile duct exploration via laparoscopic-assisted selective small incision.The operation conditions, T-tube drainage volume, bile duct pressure, and operational complications were observed.Results No significant differences in gastrointestinal recovery time, T-tube drainage volume and bile duct pressure on postoperational 1d, residual stone, and bile leakage between the two groups were observed.But bleeding volume, gastrointestinal recovery time, hospitalization time, and T-tube drainage and bile duct pressure on postoperational 7d of the observation group were better than those of the control group (P<0.05); the incision infection rate of the observation group was also lower than that of the control group (2.86% vs.14.29%, P<0.05).Conclusion The bile duct exploration via laparoscopic-assisted selective small incision can reduce operational bleeding volume and complications, shorten gastrointestinal recovery time, thus is worthy of clinical promotion.