Objective To compare the safety and effectiveness of laparoscopy for secondary operation to treat choledocholithiasis.Method A total of 60 cases who had secondary biliary tract operation were divided randomly into laparoscopy and open surgery groups,each group was 60 cases,then to compare the differences of blood loss,periopera-tive complications,postoperative analgesia,recovery time of gastrointestinal function,successful rate,the middle time of follow-up was 14.5 months.Results The average time of operation in laparoscopy group was(124.17 ±8.72)min,The average time of operation in open surgery group was(120.53 ±9.58)min,the two groups were no statistical differences (P>0.05),the total blood loss in laparoscopy group was(74.63 ±9.15)mL and the total blood loss in open surgery group was(113.35 ±34.25)mL,the recovery time of gastrointestinal function in laparoscopy group was(28.47 ± 4.07)h,and he recovery time of gastrointestinal function in open surgery group was(40.53 ±8.26)h,the total blood loss and the recovery time of gastrointestinal function in laparoscopy group was less than open surgery group(P<0.05). Rate of perioperative complications,the stone clearance rate and recurrence rate in the two groups had no statistical differences(P>0.05).Conclusion It is effective of laparoscopy for secondary operation to treat choledocholithiasis.%目的 评价腹腔镜在二次胆道手术治疗胆总管结石的安全性和有效性.方法 选择二次胆道手术治疗胆总管结石患者共60例,根据治疗方法不同分成腹腔镜组30例和开腹手术组30例,比较两组手术出血量、围术期并发症、术后镇痛、胃肠功能恢复时间、手术成功率等相关临床指标,随访中位时间14.5个月.结果腹腔镜组患者手术平均时间(124.17 ±8.72)min,开腹组患者手术平均时间(120.53 ±9.58)min,两组相比,差异无统计学意义(P>0.05).腹腔镜组手术患者平均出血量(74.63 ±9.15)mL,开腹手术组患者平均出血量(113.35 ±34.25)mL;腹腔镜组患者胃肠功能恢复时间(28.47 ±4.07)h,开腹手术组胃肠功能平均恢复时间(40.53 ±8.26)h,两组相比,腹腔镜组患者术中出血量及术后胃肠功能恢复时间均明显少于开腹手术组(均P<0.05).腹腔镜组及开腹手术组患者在围术期并发症发生率、结石清除率和复发率等指标差异无统计学意义(P>0.05).结论 与传统开腹手术相比,腹腔镜胆总管取石术在二次胆道手术中具有较好的安全性和有效性.
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