目的 分析腹腔镜胆总管探查术（LCBDE）治疗胆总管结石的效果。方法 选取2018年1月—2023年4月收治的200例胆总管结石患者作为研究对象,根据不同的手术方式分为观察组（LCBDE术）和对照组（开腹手术）,每组各100例;比较两组术中情况、术后恢复指标和并发症情况。结果 与对照组相比,观察组手术时间和出血量显著减少（P<0.01）,且在胆汁引流量、肛门排气恢复时间和住院时间方面均优于对照组（P<0.01）。此外,观察组并发症发生率明显低于对照组（P<0.05）。结论 LCBDE是一种创伤小、恢复快、并发症少的手术方法,在治疗胆总管结石方面具有广泛应用前景。
Objective To analyze the effect of laparoscopic common bile duct exploration （LCBDE） on common bile duct stones. Methods A total of 200 patients with choledocholithiasis treated from January 2018 to April 2023 were selected as study subjects. According to different surgical methods， they were divided into observation group （LCBDE） and control group （open surgery）， with 100 cases in each group. The intraoperative conditions， postoperative recovery indicators， and complications of the two groups were compared. Results Compared with the control group， the observation group showed a significant reduction in surgical time and bleeding volume （P<0.01）， and performed better in indicators such as bile drainage volume， anal exhaust recovery time， and hospital stay （all P<0.01）. In addition， the overall incidence of complications in the observation group was significantly reduced （P<0.05）. Conclusion LCBDE is a surgical method with less trauma， fast recovery， and few complications， and has a wide application prospect in the treatment of choledocholithiasis.
[1] 黄健. 腹腔镜下胆总管切开取石术与经胆囊管取石术治疗胆总管结石伴胆囊结石患者疗效分析[J]. 实用肝脏病杂志,2018,21(2):269-272.
[2] 尹飞飞,李学民,马超,等.腹腔镜胆道镜联合钬激光碎石技术在复杂嵌顿胆管结石治疗中的应用价值研究[J]. 中国现代普通外科进展,2022,25(12):952-955.
[3] 韦邦仅,周信竹,卢绪信.腹腔镜胆道探查术与传统开腹手术治疗胆囊结石并胆总管结石的疗效比较[J]. 海南医学,2018,29(10):121-123.
[4] 杨成志. 腹腔镜胆总管探查术后胆总管一期缝合与T管引流的临床比较[J]. 实用医技杂志,2018,25(6):647-648.
[5] Yang Y, He J C, Cheng S, et al.Clinical efficacies of free endoscopic nasobiliary drainage in primary duct closure following laparoscopic common bile duct exploration: a multicenter retrospective study (a report of 312 cases)[J]. Chinese Journal of Digestive Surgery, 2018, 17(1): 68-75.
[6] 陈铁炯,郑军.腹腔镜联合胆道镜与传统开腹手术治疗胆囊结石合并胆总管结石临床对比分析[J].中华全科医学,2018,16(2):226-228.
[7] Parra-Membrives P, Martínez-Baena D, Lorente-Herce JM, et al.Choledocholithiasis recurrence following laparoscopic common bile duct exploration[J]. Cir Esp (Engl Ed), 2019, 97(6): 336-342.
[8] Singh AN, Kilambi R.Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with gallbladder stones with common bile duct stones: systematic review and Meta-analysis of randomized trials with trial sequential analysis[J]. Surg Endosc, 2018, 32(9): 3763-3776.
[9] 彭沙沙,裴斐,王璟,等.腹腔镜胆总管探查取石术在既往有上腹部手术史患者中的应用[J]. 国际外科学杂志,2020,47(6):374-378.
