目的 探讨腹腔镜胆总管切开取石T管引流术的临床疗效.方法 选择2008年4月至2010年7月我院采用腹腔镜下行胆总管切开取石T管引流术治疗的32例胆囊结石并胆总管结石患者作为治疗组,选择同期进行开腹手术治疗的40例胆结石患者作为对照组,对两组患者的手术时间、住院时间以及术后并发症进行对比.结果 治疗组患者手术时间100～ 210 min,平均(139.2±31.5) min,术后第2天即能进食.住院天数3～6天,平均(4.1±0.6)天.治疗组的住院时间显著短于对照组.治疗组32例患者术后胆道残留结石2例,经T管纤维胆道镜再取石后痊愈.对照组1例发生术后胆道大出血,经缝扎后得以止血.结论 腹腔镜胆总管切口取石T管引流术手术切口较小,对胆道的创伤较小,术后恢复较快.%Objective To explore the clinical efficacy of laparoscopic choledocholithotomy with T-tube drainage.Methods 32 patients with gallstones and choledocholith who had received laparoscopic choledocholithotomy with T-tube drainage from April 2008 to July 2010 in our hospital were included in the study group,while 40 patients with gallstones who had received laparotomy for stone removal during the same period was used as control.Surgical duration,length of hospital stay,and postoperative complications were compared.Results In the study group,surgical duration was 100 to 210min,with an average of ( 139.2 ± 31.5 )min,and patients could eat on day 2; length of hospital stay was 3 to 6 days,with an average of( 4.1 ± 0.6 )days.Length of hospital stay was significantly shorter in the study group than in the control group.Two patients in the study group had residual stones after the procedure and were cured after stone removal by choledochofiberscopy via the T-tube.One patient in the control group developed massive biliary tract bleeding and needed suture for hemostasis.Conclusions Laparoscopic choledocholithotomy with T-tube drainage is less invasive to the biliary tract.Patients have smaller incision sites and recover rapidly after the procedure.
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