腹腔镜联合纤维胆道镜手术对胆总管结石 伴胆囊结石患者的影响

Effect of Laparoscopic Surgery Combined with Fiberoptic Choledochoscopy on Patients with Common Bile Duct Stones and Gallstones

摘要: 目的：观察胆总管结石伴胆囊结石患者接受腹腔镜联合纤维胆道镜手术的临床效果。方法：选择2020年8月~2024年8月前来我院进行胆总管结石伴胆囊结石的患者80例，采用双盲法均分对照组(40例，开腹手术)与观察组(40例，腹腔镜联合纤维胆道镜手术)，比较组间手术指标、疗效、术后应激指标、并发症以及术后12个月的复发率。结果：对比对照组，观察组住院时间、胃肠道功能恢复时间以及手术时间较短，术中出血量较少，差异明显(P < 0.05)；观察组疗效总有效率显著较高，观察组并发症总发生率较低，组间差异明显(P < 0.05)；对比对照组，观察组应激指标水平较低，组间差异明显(P < 0.05)。观察组、对照组术后12个月的复发率分别为2.50%、15.00% (P < 0.05)。结论：腹腔镜联合纤维胆道镜手术在治疗胆总管结石伴胆囊结石患者中，可减轻手术创伤，降低应激反应及并发症发生率，促进术后恢复，并在一定程度上降低术后复发风险，具有较好的临床应用价值。

Abstract: Objective: To observe the clinical effect of laparoscopic surgery combined with fiberoptic choledochoscopy in the treatment of common bile duct stones complicated with gallbladder stones. Methods: A total of 80 patients with common bile duct stones complicated with gallbladder stones admitted to our hospital from August 2020 to August 2024 were selected and divided into the control group and the observation group by random number table method, with 40 cases in each group. The control group received open surgery, while the observation group received laparoscopic surgery combined with fiberoptic choledochoscopy. Surgical indicators, clinical efficacy, postoperative complications, stress indicators and recurrence within 12 months were compared between the two groups. Results: Compared with the control group, the observation group had shorter hospitalization time, gastrointestinal function recovery time and operation time, and less intraoperative blood loss, with significant differences (P < 0.05); the total effective rate of treatment in the observation group was significantly higher, and the total incidence of complications in the observation group was lower, with significant differences between the groups (P < 0.05); compared with the control group, the levels of stress indicators in the observation group were lower, with significant differences between the groups (P < 0.05). The recurrence rates at 12 months after surgery in the observation group and the control group were 2.50% and 15.00%, respectively (P < 0.05). Conclusion: Laparoscopy combined with fibrous choledochoscopy has the advantages of less surgical trauma, faster postoperative recovery, and fewer complications in the treatment of patients with common bile duct stones and gallstones, and it can also reduce the postoperative recurrence rate, making it worthy of clinical application and promotion.