Abstract:【Objective】To explore the effect of laparoscopic biliary exploration in the treatment of common bile duct stores under both conventional and modified approaches. 【Methods】Eighty-six patients with gallstones who underwent laparoscopic exploration were selected in our hospital. Patients were divided into experimental group and the control group, 43 cases in each group. The experimental group used a modified approach, while the control group used a conventional approach. The intraoperative blood loss, common bile duct suture time, gastrointestinal function recovery time, and hospitalization time were compared between the two groups. The levels of albumin (ALB) and total bilirubin (TBIL), complications and recurrence of stones were compared as well. 【Results】In the experimental group, the common bile duct suture time, incision length, gastrointestinal function recovery time and hospitalization time were lower than those in the control group(P<0.05). The levels of ALB after surgery in the two groups were higher than those before surgery, and the levels of TBIL after surgery in both groups were lower than those before surgery(P<0.05). However, there was no significant difference between the two groups either before or after surgery, respectively (P>0.05). The incidence of bile leakage, celiac bleeding, heart failure, urinary retention, and biliary stenosis was lower in the experimental group than in the control group, and the difference was statistically significant (P<0.05).【Conclusion】 Modified laparoscopic biliary exploration for the treatment of common bile duct stones can shorten the time of suturing of the common bile duct. The surgical incision is small, the incidence of postoperative complications is low, and the safety is high. It is worthy of clinical application.
邓安. 常规入路和改良入路腹腔镜胆道探查术治疗胆总管结石的临床疗效比较[J]. 医学临床研究, 2019, 36(8): 1512-1513.
DENG An. Outcome Comparison between Conventional Approach and Modified Approach of Laparoscopic Biliary Exploration. JOURNAL OF CLINICAL RESEARCH, 2019, 36(8): 1512-1513.
[1] 杨波,莫立显,张武坤.腹腔镜下胆总管切开胆道镜探查取石术的临床体会[J].中国处方药,2017,(4):132-133. [2] Facchiano E, Soricelli E, Leuratti L,et al. Intussusception after roux-en-y gastric bypass: laparoscopic management[J].Obes Surg,2018,28(7):2145-2147. [3] 华龙,王晨宇,张军杰,等.对比分析腹腔镜胆道探查术与传统开腹手术治疗胆囊结石合并胆总管结石的临床效果[J].中国实用医药,2016,11(1):61-63. [4] Takalkar YP,Koranne MS.Laparoscopic cholecystectomy with choledochoduodenostomy in a patient with situs inversus totalis[J].J Minim Access Surg,2018,14(3):241-243. [5] 秦菊芳,吴雅荣.腹腔镜胆囊切除胆道探查术和传统开腹手术治疗胆囊结石合并胆总管结石的临床疗效比较[J].河北医学,2015,21(12):2004-2006. [6] 牛小娟,宋京海,陈剑, 等.腹腔镜下经胆囊管汇入部微切开途径行胆道探查术在老年胆总管结石患者中的应用[J].中华老年医学杂志,2016,35(9):960-963. [7] 向桂华.改良入路及胆管途径入路腹腔镜胆道探查术治疗老年胆总管结石的疗效[J].实用医学杂志,2017,33(16):2706-2710. [8] Zaidan LR, Ahmed EK, Halimeh B, et al. Long standing biliary colic masking chylous ascites in laparoscopic roux-en-Y gastric bypass; a case report[J].BMC Surg,2018,18(1):43.