Zhao Yunqing, Tao Hongbo, Liu Yanqin, Sha Gen, Yi Xianyun, Qin Qin, Jin Dong, He Chengjie, Wu Xianghong, Zhou Qing
Department of General Surgery, Wuhan Wudong Hospital (Wuhan Second Psychiatric Hospital), Wuhan, China.
Department of Anesthesiology, Wuhan Wudong Hospital (Wuhan Second Psychiatric Hospital), Wuhan, China.
Front Surg. 2022 Apr 27;9:880266. doi: 10.3389/fsurg.2022.880266. eCollection 2022.
To investigate the effectiveness and clinical value of cholangiography in the diagnosis of bile duct stones in laparoscopic cholecystectomy.
200 patients who underwent laparoscopic cholecystectomy in our hospital from January 2017 to January 2019 were randomly divided into research group and control group, with 100 cases in each group. The research group underwent choledochotomy and exploration with the help of choledochoscope, while the control group underwent cholangiography to diagnose bile duct stones. The cure rate, residual stone rate, complication rate, intraoperative bleeding, hospital stay and patient satisfaction were compared between the two groups.
in the control group, 9 cases were converted to laparotomy, 20 cases of common bile duct stones, 10 cases of bile duct injury and 6 cases of common bile duct variation. In the research group, there were 2 cases of conversion to laparotomy, 12 cases of common bile duct stones, 2 cases of bile duct injury and 4 cases of common bile duct variation. The cure rate of the researchgroup was higher than that of the control group, There was significant difference between the two groups ( < 0.05). The residual amount of stones in the research group was lower than that in the control group, and there was significant difference between the two groups ( < 0.05). The incidence of postoperative complications in the research group was lower than that in the control group, and there was significant difference between the two groups ( < 0.05). The patient satisfaction in the research group was higher than that in the control group, and there was significant difference between the two groups ( < 0.05). The intraoperative blood output of the research group was lower than that of the observation group, and there was significant difference between the two groups ( < 0.05).
cholangiography is an effective method for the diagnosis of bile duct stones in laparoscopic cholecystectomy. Clarifying the variation and anatomical structure of bile duct is helpful to improve the surgical cure rate, reduce the residual rate of postoperative stones and the incidence of complications, reduce the amount of intraoperative bleeding, shorten the hospital stay, and promote the postoperative rehabilitation of patients.
探讨胆管造影在腹腔镜胆囊切除术中诊断胆管结石的有效性及临床价值。
选取2017年1月至2019年1月在我院行腹腔镜胆囊切除术的200例患者,随机分为研究组和对照组,每组100例。研究组在胆总管切开后借助胆总管镜进行探查,而对照组采用胆管造影诊断胆管结石。比较两组的治愈率、残石率、并发症发生率、术中出血量、住院时间及患者满意度。
对照组中转开腹9例,胆总管结石20例,胆管损伤10例,胆总管变异6例。研究组中转开腹2例,胆总管结石12例,胆管损伤2例,胆总管变异4例。研究组治愈率高于对照组,两组比较差异有统计学意义(<0.05)。研究组残石量低于对照组,两组比较差异有统计学意义(<0.05)。研究组术后并发症发生率低于对照组,两组比较差异有统计学意义(<0.05)。研究组患者满意度高于对照组,两组比较差异有统计学意义(<0.05)。研究组术中出血量低于观察组,两组比较差异有统计学意义(<0.05)。
胆管造影是腹腔镜胆囊切除术中诊断胆管结石的有效方法。明确胆管变异及解剖结构有助于提高手术治愈率,降低术后残石率及并发症发生率,减少术中出血量,缩短住院时间,促进患者术后康复。