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首页> 外文期刊>Surgical Endoscopy >Laparoscopic common bile duct exploration versus open surgery: Comparative prospective randomized trial
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Laparoscopic common bile duct exploration versus open surgery: Comparative prospective randomized trial

机译：腹腔镜胆总管探查与开放性手术：比较性前瞻性随机试验

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The aim of the study was to analyse safety and benefits of laparoscopic common bile duct (CBD) exploration compared to open. Prospective randomized trial included a total of 256 patients with CBD stones operated from 2005 to 2009 years in a single center. There were two groups of patients: group I-laparoscopic CBD exploration (138 patients), group II-open CBD exploration (118 patients). Patient comorbidity was assessed by means of the American Society of Anesthesiology (ASA) score; i.e. ASA II-109 patients, ASA III-59 patients. Bile duct stones were visualized preoperatively by means of US examination in 129 patients, by means of ERCP in 26 patients, by magnetic resonance cholangiopancreatography in 72 patients. Preoperative evaluation was done through medical history, biochemical tests and ultrasonography. There was no statistical significant difference between 2 groups of patients. No mortality occurred. The mean duration of laparoscopic operations was 82 min (range, 40-160 min). The mean duration of open operations were 90 min (range, 60-150 min). Mean blood loss was much less in laparoscopic group than in open group (20±2 vs. 285±27 ml; p<0.01). Postoperative complications were observed is nine patients of laparoscopic group and in 15 patients in open group (p<0.01). There were 102 attempts to perform transcystic exploration of CBD. External drainage was used in 25 (32.8%) patients with transcystic approach. Conversion to laparotomy was performed in two patients. Open operations were performed in 118 patients with choledocholithiasis. External drainage was used in 85% of patients. Morbidity in open group was higher (12.7%) than in laparoscopic group (6.5%). Laparoscopic CBD exploration can be performed with high efficiency, minimal morbidity and mortality. Laparoscopic procedures have advances over open operations in terms of postoperative morbidity and length of hospital stay.
机译：该研究的目的是分析与开放性腹腔镜胆总管（CBD）相比的安全性和益处。前瞻性随机试验包括2005年至2009年在同一中心手术的256例CBD结石患者。患者分为两组：I组-腹腔镜CBD探查（138例），II组-开放CBD探查（118例）。患者合并症通过美国麻醉学会（ASA）评分进行评估;即ASA II-109患者，ASA III-59患者。术前通过US检查129例，通过ERCP术26例，通过磁共振胆胰胰管造影术72例，对胆管结石进行了可视化检查。通过病史，生化检查和超声检查进行术前评估。两组患者之间无统计学差异。没有死亡发生。腹腔镜手术的平均持续时间为82分钟（范围为40-160分钟）。打开手术的平均持续时间为90分钟（范围为60-150分钟）。腹腔镜组的平均失血量少于开放组（20±2 vs. 285±27 ml; p <0.01）。观察到腹腔镜组9例和开放组15例的术后并发症（p <0.01）。有102次尝试进行CBD的跨囊探查。 25例（32.8％）经囊性入路患者采用了外部引流。两名患者进行了开腹手术。在118例胆总管结石患者中进行了开放手术。 85％的患者使用了外部引流。开放组的发病率（12.7％）高于腹腔镜组（6.5％）。腹腔镜CBD探查可以高效，低发病率和低死亡率进行。在术后发病率和住院时间方面，腹腔镜手术比开放手术有了进步。

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