腹腔镜加胆道镜联合钬激光碎石术治疗胆总管结石和肝结石的有效性和安全性分析

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY
Gastroenterology Research Pub Date : 2024-06-01 Epub Date: 2024-06-29 DOI:10.14740/gr1710
Hui Li, Qun Feng Zhong, Qiong Rong Liu, Qiang Wu, Wen Zhang, Guo Pei Luo
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引用次数: 0

摘要

背景:随着腹腔镜技术的发展,腹腔镜、胆道镜和钬激光碎石术的联合应用已成为治疗胆总管结石和肝结石的有效方法。本研究旨在评估这种方法的有效性和安全性:对 2021 年 4 月至 2023 年 3 月期间确诊的 76 例胆总管结石和肝结石患者的病历进行回顾性分析。根据治疗方案将患者分为两组:对照组,接受传统开腹手术和胆道镜碎石术(38 人);实验组,接受腹腔镜联合胆道镜和钬激光碎石术(38 人)。对两组的各种手术相关参数、无结石率、并发症发生率以及生化指标、肝功能指标、炎症指标、应激反应指标和疼痛评分的变化进行了比较分析:结果:与对照组相比,实验组结石取出时间明显缩短,术中出血减少,住院时间缩短(P < 0.05)。此外,实验组的术后并发症发生率较低,术后 2 周至 3 个月的疼痛评分也较低(P < 0.05)。与对照组相比,观察组的总胆汁酸(TBA)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)和谷氨酰转肽酶(GGT)等生化指标明显降低(P < 0.05)。此外,实验组的应激和炎症指标也较低(P < 0.05):结论:腹腔镜、胆道镜和钬激光碎石术的联合应用在胆总管结石和肝结石的治疗中取得了良好的疗效,表明其具有广泛的临床应用潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Analysis of Efficacy and Safety of Laparoscopy Plus Choledochoscopy Combined With Holmium Laser Lithotripsy for Choledocholithiasis and Hepatolithiasis.

Background: With the advancement of laparoscopic technology, the combination of laparoscopy, choledochoscopy, and holmium laser lithotripsy has emerged as an effective treatment modality for both choledocholithiasis and hepatolithiasis. This study aimed to assess the efficacy and safety of this approach.

Methods: Retrospective analysis was conducted on the medical records of 76 patients diagnosed with choledocholithiasis and hepatolithiasis between April 2021 and March 2023. Patients were divided into two groups based on the treatment plan: the control group, which underwent traditional laparotomy and choledochoscopy lithotripsy (n = 38), and the experimental group, which underwent laparoscopy combined with choledochoscopy and holmium laser lithotripsy (n = 38). Comparative analysis was performed on various operation-related parameters, stone-free rate, complication rates, and changes in biochemical, liver function, inflammatory, stress response indicators, and pain scores between the two groups.

Results: The experimental group demonstrated significantly shorter stone removal time, reduced intraoperative bleeding, and shorter hospital stay compared to the control group (P < 0.05). Moreover, the experimental group exhibited lower incidence of postoperative complications and lower pain scores at 2 weeks to 3 months post-operation (P < 0.05). Biochemical indicators including total bile acid (TBA), total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and glutamyl transpeptidase (GGT) were significantly lower in the observation group compared to the control group (P < 0.05). Additionally, stress and inflammation indicators were also lower in the experimental group (P < 0.05).

Conclusions: The combination of laparoscopy, choledochoscopy, and holmium laser lithotripsy presents favorable therapeutic outcomes in the management of choledocholithiasis and hepatolithiasis, indicating its potential for widespread clinical application.

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Gastroenterology Research
Gastroenterology Research GASTROENTEROLOGY & HEPATOLOGY-
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