Effect of laparoscopy combined with choledochoscopy in the treatment of extrahepatic bile duct stones
腹腔镜联合胆道镜治疗肝外胆管结石的效果

摘要

目的 分析肝外胆管结石患者运用腹腔镜联合胆道镜治疗的有效性。方法 选择我院在2022年6月至2024年6月接诊的60例肝外胆管结石患者，基于掷骰子法分为两组，传统组30例接受传统开腹手术治疗，探究组30例接受腹腔镜联合胆道镜治疗，对两组治疗总有效率、手术相关指标、肝功能指标、炎症指标、并发症发生率开展对比。结果 探究组治疗总有效率96.67%高于传统组73.33%，（χ2=6.4052，P=0.0113）。术中出血量、首次排气时间、首次下床时间和住院时间相比，探究组均小于传统组，P＜0.05。丙氨酸氨基转移酶、天冬氨酸氨基转移酶、C反应蛋白、肿瘤坏死因子-α对比，探究组术后均小于传统组，P＜0.05。并发症发生率相比，探究组低于传统组，P＜0.05。结论 肝外胆管结石采用腹腔镜联合胆道镜治疗效果显著，值得推广。

Abstract

Objective To analyze the effectiveness of laparoscopy combined with choledochoscopy in the treatment of patients with extrahepatic bile duct stones.
Methods A total of 60 patients with extrahepatic bile duct stones admitted to our hospital from June 2022 to June 2024 were selected and divided into two groups based on the dice rolling method. Thirty cases in the traditional group received traditional laparotomy, and 30 cases in the exploration group received laparoscopy combined with choledochoscopy. The total effective rate, surgery-related indicators, liver function indicators, inflammatory indicators, and complication rates of the two groups were compared.
Results The total effective rate of the exploration group was 96.67%, which was higher than that of the traditional group (73.33%) (χ2=6.4052, P=0.0113). The amount of intraoperative blood loss, time to first flatus, time to first getting out of bed, and length of hospital stay were all lower in the exploration group than in the traditional group (P<0.05). Alanine aminotransferase, aspartate aminotransferase, C-reactive protein, and tumor necrosis factor-α were compared in the exploratory group after surgery, which were lower than those in the traditional group (P < 0.05). The incidence of complications was lower in the exploratory group than in the traditional group (P < 0.05).
Conclusion   The effect of laparoscopy combined with choledochoscopy in the treatment of extrahepatic bile duct stones is significant and worthy of promotion.