■随着腹腔镜技术的进步,腹腔镜的结合,胆道镜检查,钬激光碎石术已成为胆总管结石和肝胆管结石的有效治疗方法。本研究旨在评估这种方法的有效性和安全性。
■对2021年4月至2023年3月期间诊断为胆总管结石和肝胆管结石的76例患者的医疗记录进行了回顾性分析。根据治疗方案将患者分为两组:对照组,行传统开腹手术和胆道镜碎石术(n=38),和实验组,行腹腔镜联合胆道镜和钬激光碎石术(n=38)。对各种操作相关参数进行了比较分析,无石率,并发症发生率,和生化的变化,肝功能,炎症,应激反应指标,两组之间的疼痛评分。
■实验组的取石时间明显缩短,减少术中出血,住院时间较对照组短(P<0.05)。此外,实验组术后并发症发生率较低,术后2周~3个月疼痛评分较低(P<0.05)。生化指标包括总胆汁酸(TBA),总胆红素(TBIL),丙氨酸氨基转移酶(ALT),天冬氨酸转氨酶(AST),碱性磷酸酶(ALP),观察组谷氨酰转肽酶(GGT)水平明显低于对照组(P<0.05)。此外,实验组的应激和炎症指标也较低(P<0.05)。
■腹腔镜检查的结合,胆道镜检查,和钬激光碎石术在治疗胆总管结石和肝胆管结石方面具有良好的治疗效果,表明其广泛临床应用的潜力。
UNASSIGNED: With the advancement of laparoscopic technology, the combination of laparoscopy,
choledochoscopy, and holmium laser lithotripsy has emerged as an effective treatment modality for both choledocholithiasis and hepatolithiasis. This study aimed to assess the efficacy and safety of this approach.
UNASSIGNED: Retrospective analysis was conducted on the medical records of 76 patients diagnosed with choledocholithiasis and hepatolithiasis between April 2021 and March 2023. Patients were divided into two groups based on the treatment plan: the control group, which underwent traditional laparotomy and
choledochoscopy lithotripsy (n = 38), and the experimental group, which underwent laparoscopy combined with
choledochoscopy and holmium laser lithotripsy (n = 38). Comparative analysis was performed on various operation-related parameters, stone-free rate, complication rates, and changes in biochemical, liver function, inflammatory, stress response indicators, and pain scores between the two groups.
UNASSIGNED: The experimental group demonstrated significantly shorter stone removal time, reduced intraoperative bleeding, and shorter hospital stay compared to the control group (P < 0.05). Moreover, the experimental group exhibited lower incidence of postoperative complications and lower pain scores at 2 weeks to 3 months post-operation (P < 0.05). Biochemical indicators including total bile acid (TBA), total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and glutamyl transpeptidase (GGT) were significantly lower in the observation group compared to the control group (P < 0.05). Additionally, stress and inflammation indicators were also lower in the experimental group (P < 0.05).
UNASSIGNED: The combination of laparoscopy,
choledochoscopy, and holmium laser lithotripsy presents favorable therapeutic outcomes in the management of choledocholithiasis and hepatolithiasis, indicating its potential for widespread clinical application.