| Objective: This study was to compare the traditional laparotomy surgery treatment and application of modern cavity mirror the clinical curative effect of minimally invasive surgery in patients with clinical data. Generally, preoperative clinical data, such as the blood tests after operation, changes in vital signs, complications after the operation, intraoperative situation related to the operation indexes and so on, in order to provide the reference for elderly patients with gallbladder and bile duct calculi treatment method.Methods: Select 108 cases aged from70 years to 85 years with the gallbladder and common bile duct calculi cases from June 2012 to June 2013 in the hospital accepted biliary tract surgery treatment data. The 108 cases was divided into three groups according to the different surgery way,group A and group B, group C.Compare data of Finish time statistics used by surgery, surgical blood loss, patients with postoperative complications, vital signs, postoperative patients with preoperative blood tests bilirubin and transaminase, white blood cells back to normal time calculation and so on, to evaluate the clinical efficacy of the three different kinds of operations.Results: 1.Preoperative clinical data:there were no significant differences(p>0.05). 2.Intraoperative indicators:group B used shoter time than group A and group C, the total blood loss less than group A and group B(p<0.05);And group C used less time than group A(p<0.05), blood loss of group A more than group C(p<0.05). 3.The postoperative recovery index:group A and group C temperature fluctuations were significantly higher than group B,(p<0.05); And group C gastrointestinal function recovery time is less than laparotomy group A(p<0.05),but the three groups of patients with preoperative blood biochemical assay was no significant difference,(p>0.05). 4.The surgical curative effect and complications : all the cases are performed successfully and recover smoothly, three groups of cases operation success rate no difference;three groups of cases of postoperative complications is no difference(p>0.05).5.The length of time:The confinement and postoperative hospitalization days of group A group C is more than group B patients(p<0.05);And group A group C compared between two groups of total hospitalization days, there was no significant difference(p>0.05).Conclusion: 1.Age greater than 70-year-old patients with cholelith disease, gallbladder and common bile duct calculi, especially when there is a merger of cholecystitis cholangitis in disease progress rapidly, to quickly to block the biliary tree infection to severe infection treatment principle should strive to safe, rapid, simple and efficient. Because the EST+LC double mirror combination has been widely used in practice to prove safer, and have many advantages, can maximum limit reduced to patients with abdominal injury and can bring patients psychological comfort, can effectively reduce caused by open operation of intestinal adhesion complications, such as early recovery of gastrointestinal function can be resumed as soon as possible on diet, shorten hospitalization time corresponding easing the burden on the patient, so treating senile cholelith disease can be used as the preferred solution. 2.The LC+LCBDE+IOC has advantage than traditional open surgery to restore, small abdominal trauma, quicker recovery of gastrointestinal function, low incidence of intestinal adhesion of advantages, it also has the corresponding application space, but as a result of the operation requires patients to tolerate pneumoperitoneum, bile duct diameter smaller, such as strict conditions, so the need to pay attention to grasp the corresponding clinical indications. But the traditional open surgery is still the basis of minimally invasive technology and strong backing. |
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