腹腔镜胆总管探查一期缝合治疗老年胆总管结石的临床疗效分析

发布时间：2018-11-24 13:40

【摘要】：目的:探讨老年胆总管结石患者行腹腔镜胆总管探查(LCBDE)一期缝合的安全性与有效性。方法:回顾性分析2012年12月—2016年12月期间收治的146例胆囊结石合并胆总管结石行LCBDE一期缝合患者的临床与随访资料,根据年龄分两组,61例≥65岁者为老年组,85例65岁为非老年组。比较两组患者的相关临床指标。结果:146例患者LCBDE一期缝合手术均顺利完成,无中转开腹。与非老年组比较,老年组手术时间(90.98 min vs.93.12 min)、术中出血量(25.08 mL vs.24.94 mL)、胆总管结石数(2.36个vs.1.98个)差异均无统计学意义(均P0.05),术后腹腔引流时间(4.74 d vs.4.13 d)、下床时间(1.87 d vs.1.61 d)、胃肠功能恢复时间(2.43 d vs.2.05 d)、住院时间(7.46 d vs.6.62 d)明显延长(均P0.05)。两组均无严重并发症发生,两组术后胆汁漏(9.8%vs.9.4%)、术后腹腔出血(1.6%vs.2.4%)、残余结石(1.6%vs.1.2%)、结石复发率(1.6%vs.0)差异均无统计学意义(均P0.05)。结论:LCBDE一期缝合处理老年胆总管结石安全、有效,在准确把握手术指证前提下,可作为老年胆总管结石患者优先选择的术式。
[Abstract]:Objective: to evaluate the safety and efficacy of laparoscopic choledocholithiasis for primary (LCBDE) suture in elderly patients with choledocholithiasis. Methods: the clinical and follow-up data of 146 patients with cholecystolithiasis complicated with choledocholithiasis treated by LCBDE primary suture from December 2012 to December 2016 were analyzed retrospectively. According to their age, 61 patients with choledocholithiasis and choledocholithiasis were divided into two groups. 85 cases aged 65 years were non-elderly group. To compare the related clinical indexes between the two groups. Results: one-stage suture of LCBDE was performed successfully in 146 patients. Compared with the non-elderly group, the operative time of the elderly group was 90.98 min vs.93.12 min), (25.08 mL vs.24.94 mL),). There was no significant difference in the number of choledocholithiasis (2.36 vs.1.98) (P0.05), and the postoperative time of abdominal drainage (4.74 d vs.4.13 d), 1.87 d vs.1.61 d),) The recovery time of gastrointestinal function (2.43 d vs.2.05 d), hospitalization time 7.46 d vs.6.62 d) was significantly prolonged (P0.05). There were no serious complications in both groups. Bile leakage (9.8vs.9.4%), intraperitoneal hemorrhage (1.6vs.2.4%) and residual stones (1.6vs.1.2%) were found in both groups. The recurrence rate of stone (1.6%vs.0) was not significantly different (P0.05). Conclusion: the primary suture of LCBDE is safe and effective in the treatment of choledocholithiasis in the elderly.
【作者单位】：首都医科大学宣武医院普通外科;
【基金】：北京市卫生系统高层次卫生技术人才基金资助项目(2014-3-058) 人社部留学人员科技活动择优资助项目(008-0095)
【分类号】：R657.42

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