腹腔镜联合硬质胆道镜弹道碎石取石术治疗肝胆管结石患者的临床分析

摘要/Abstract

摘要：

目的评估肝胆管结石患者接受腹腔镜 + 硬质胆道镜弹道碎石取石术的临床效果。方法选取2018 年 1 月至 2019 年 12 月东莞市凤岗医院接受传统手术治疗的 25 例患者纳入对照组，将 2020 年 1 月至2024 年 8 月东莞市凤岗医院接受腹腔镜 + 硬质胆道镜弹道碎石取石术治疗的 25 例患者纳入观察组，评价组间围手术期参数、免疫功能、并发症、肝功能情况。结果观察组患者的手术用时、胃肠功能恢复时间、住院时间均短于对照组，术中出血量少于对照组，且残石发生率低于对照组，差异均有显著性（P ＜ 0.01）。术前，两组患者的 IgA、IgM、IgG 水平、肝功能指标比较无显著差异（P ＞ 0.05）。术后，观察组患者的IgA、IgM、IgG 水平均高于对照组，γ- 谷氨酰基转移酶、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶水平，以及结合胆红素、总胆汁酸及总胆红素水平均低于对照组，差异均有显著性（P ＜ 0.001）。对照组并发症总发生率为 24.00%，观察组为 4.00%，差异有显著性（P ＜ 0.001）。结论腹腔镜 + 硬质胆道镜弹道碎石取石术治疗肝胆管结石可以优化围手术期参数，减少并发症，改善肝功能与胆汁生化指标。

关键词: 腹腔镜, 硬质胆道镜弹道碎石取石术, 肝胆管结石

Abstract:

Objective To evaluate the clinical efficacy of laparoscopic and rigid cholangioscopy ballistic lithotripsy for patients with liver and bile duct stones. Method 25 patients who received traditional surgical treatment at Fenggang Hospital in Dongguan City from January 2018 to December 2019 were selected as the control group, and 25 patients who received laparoscopic+rigid cholangioscopy ballistic lithotripsy treatment at Fenggang Hospital in Dongguan City from January 2020 to August 2024 were selected as the observation group. The perioperative parameters, immune function, complications, and liver function between the groups were evaluated. Result The surgical time, gastrointestinal function recovery time, and hospitalization time of the observation group were shorter than those of the control group. The intraoperative bleeding volume was less than that of the control group, and the incidence of residual stones was lower than that of the control group, with significant differences (P ＜ 0.01). Before surgery, there was no significant difference in IgA, IgM, IgG levels, and liver function indicators between the two groups of patients (P ＞ 0.05). After surgery, the levels of IgA, IgM, and IgG in the observation group were higher than those in the control group, while the levels of gamma glutamyl-transferase, aspartate transferase, alanine amino-transferase, conjugated bilirubin, total bile acids, and total bilirubin were lower than those in the control group, with significant differences (P ＜ 0.001). The total incidence of complications in the control group was 24.00%, while in the observation group it was 4.00%, with a significant difference (P ＜ 0.001). Conclusion Laparoscopic and rigid cholangioscopy ballistic lithotripsy for patients with liver and bile duct stones can optimize perioperative parameters, minimize complications, and improve liver function and bile biochemical indicators.

Key words: Laparoscopy, Rigid cholangioscopy ballistic lithotripsy for stone removal, Hepatic calculus

王茂强, 黄涛, 赵建波, 孙海峰, 陈正修, 何灵生, 王建宇, 梁锋, 廖剑明, 黄焕基. 腹腔镜联合硬质胆道镜弹道碎石取石术治疗肝胆管结石患者的临床分析 [J]. 临床普外科电子杂志, 2025, 13(2): 60-.

Wang Maoqiang, Huang Tao, Zhao Jianbo, Sun Haifeng, Chen Zhengxiu, He Lingsheng, Wang Jianyu, Liang Feng, Liao Jianming, Huang Huanji. Clinical analysis of laparoscopic combined with rigid cholangioscopy ballistic lithotripsy for the treatment of patients with liver and bile duct stones [J]. Journal of General Surgery for Clinicians, 2025, 13(2): 60-.

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腹腔镜联合硬质胆道镜弹道碎石取石术治疗肝胆管结石患者的临床分析

Clinical analysis of laparoscopic combined with rigid cholangioscopy ballistic lithotripsy for the treatment of patients with liver and bile duct stones

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